Village of Farmingdale
361 Main Street • Farmingdale, NY 11735
(516) 249-0093 • www.farmingdalevillage.com
VI
LLAGE RESIDENT
RAILROAD PARKING PERMIT
APPLICATION
Office Use
Check
Yearly Fee: $100 Payable to: Village of Farmingdale
All Permits Expire January 31st
Permit # Ck # Amt. $
Replacement Old # Cash $
N
ame: Date:
Address:
Year/Make/Model/Color of Vehicle:
License Plate No.:
Home
Phone #: Work Phone #:
Cell
Phone #: E-mail Address:
~ Please Read and Sign Below ~
Permits Expire January 31st
New Permits Valid February 1
st
until January 31st the following year
Please mail your application to Village Hall and include the following:
COPY OF VEHICLE REGISTRATION
SELF-ADDRESSED, STAMPED ENVELOPE
CHECK OR MONEY ORDER PAYABLE TO:
Inc. Village of Farmingdale
Permits are oversold by 25% pursuant to LIRR policy.
Spaces are available on a first
come
first serve basis.
Please be aware that if a replacement permit is needed for any reason such as accident, new car, trade-in, etc., we
will not issue one unless the existing permit sticker has been returned and the new registration has been provided.
There will be a fee of $5 before a replacement can be issued.
By submitting this application, I certify that the information contained in this application,
and the supporting
documents, are true and correct.
Signature of Applicant ____________________________________________ Date _________________
