Department of Finance
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Contact the DOF Equal Employment Opportunity & Disability Services Facilitator
Tenant/Applicant Information
Full Name:
*
Street Address:
*
Apartment Number:
Borough or City:
*
-Select-
Bronx
Brooklyn
Manhattan
Queens
Staten Island
State:
*
-Select-
Alabama
Alaska
Arizona
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California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
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Michigan
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Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
*
Phone Number:
*
Email Address:
*
If you are representing a tenant or applicant please complete this section:
Representative Name:
Street Address:
Apartment Number:
Borough or City:
-Select-
Bronx
Brooklyn
Manhattan
Queens
Staten Island
State:
-Select-
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Email Address:
Please select the name of the program you need assistance with:
Program Name:
*
-Select-
Rent Freeze for People with Disabilities (DRIE)
Rent Freeze for Seniors (SCRIE)
Disabled Homeowners Exemption (DHE)
Senior Citizen Homeowners' Exemption (SCHE)
Veterans Exemption
Other (Please enter the program name in the box below)
Other Program Name:
Please provide us with the details of your inquiry.
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