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2. Please use this form to submit an inquiry related to payments Police and Fire Detail Billing
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6. Contact Information
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10. Full Name:*
12. Email Address:*
14. Address:
16. City:
18. State:
20. Zip Code:
22. Telephone Number:*
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28. Detail Billed Information
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32. Police or Fire Detail Hours:

    1. Police
    2. Fire
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36. Date In Question:*
37. Time In Question: (00:00AM/PM)*
38. Location In Question:*
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42. Comments / Questions*
Leave This Blank:


44. Submit

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