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Documents on this page may be Adobe Acrobat files. Download the free
Adobe Acrobat Reader
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If you wish to file this form on-line:
Individual Medallion Owners
All Other Persons With Ownership Interests In Medallions
If you wish to print this Form and file by mail:
Form in PDF Format
Please note that you may not assert a privacy defense to disclosure of this form under the Freedom of Information Law (FOIL) if you file online.
Copyright 2012 The City of New York
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