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Dutchess County Division of Weights and Measures Store Complaint Form


Please note your Name and Telephone number are confidential.

Please indicate type of complaint:

Date submitted:

Full name:



Name of store:

Street address of store:

City/Town/Village where store is Located:     Zip code:

Date item purchased/Date at store:

Describe item purchased (name of item and weight):

Do you have a receipt: 

Did you speak to the clerk and/or manager at the store: 

Describe complaint:

Maximum number of characters: 1,000

Office Use



Inspection Report #:






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