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Smoke/Carbon Monoxide Detector Certification

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  2. Millville Fire Department

    420 Buck Street Millville, NJ 08332

    Phone: 856-327-3334      Fax: 856-327-2319

  16. If something comes up and we can't make it, who do we call?
  18. This is Mandatory.

  22. Office Use Only

  24. Date Request Received: _____________________
  25. Received By: ______________________________
  27. Scheduled Date/Time: ______________________
  29. Amount Due:
  30. $45
  31. $90
  32. $161
  34. Date/Time Faxed to Accounts Receivable: _____________________

  42. Payment Schedule

    $45 - 10 or More Business Days

    $90 - 3 to 9 Business Days

    $161 - 2 or Less Business Days

    Days are calculated from the date that the request is received to the closing date.

    Failure to complete all requested information may delay the inspection.

  44. www.MillvilleFire.org

    Committment-Innovation-Excellence-Passion

    45. Leave This Blank:

  47. This field is not part of the form submission.