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Gov JOSEPH KELLY ACTING TREASURER AND TAX COLLECTOR PENALTY CANCELLATION REQUEST Assessor s Identification Number AIN or Assessor s Bill Number Taxpayer Name Claimant Name Mailing Address Daytime Telephone email Please indicate the type of tax bill year and installment period s for which you are requesting a penalty cancellation. If your request is for more than two tax years please submit an additional signed and dated. Annual Supplemental Prior Years Unsecured Adjusted Bill Tax Year...

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Joseph Kelly Treasurer and is a form used for reporting financial information related to a specific treasurer.

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