Find Dutchess County Government on Facebook  Get Tweets from Dutchess County Government  Web feeds from Dutchess County Government

<<< Go to Department of Behavioral & Community Health's Home Page

Dutchess County Division of Weights and Measures Gas Complaint Form


Please note your Name and Telephone number are confidential.

Please indicate type of complaint:

Date submitted:

Full name:



Name or brand of gas station:

Street address of gas station:

City/Town/Village where gas station is Located:     Zip code:

Date gas purchased:

Number of the gas pump:    OR Location of Gas Pump:

Grade/Octane of fuel purchased: 

Do you have a receipt: 

Did you pay by credit card or cash: 

Does the receipt price match the price on the pump: 

Were you charged the amount shown on the pump: 

Did you speak to the clerk at the gas station: 

If your car malfunctioned, or you experienced some other issue, what happened:

Maximum number of characters: 1,000

Office Use



Inspection Report #:






- Home -   |   - Legal Statements -   |   - How to Use this Site -   |   - Contact Us -