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TAXI MEDALLION AGENT DESIGNATION REMOVAL FORM Please visit our website for more information at: www.nyc.gov/tlcYou must complete one form per medallion. Medallion Number: To be filled in by TLC personnel
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It is a form required by the NYC government for designated agent removal.
Any entity or individual involved in designated agent removal in NYC.
The form can be filled out online or submitted in person at the designated government office.
The purpose is to inform the NYC government about designated agent removal activities.
Information about the designated agent being removed and the reason for the removal.
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