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2. 
3. TOWNSHIP OF BLOOMFIELD
   1 Municipal Plaza, Bloomfield, New Jersey 07003
5. TAX AND WATER QUESTION FORM
7. BLOCK
   If known
8. LOT
   If known
10. Name*
11. Email Address
13. Address*
15. City
16. State
17. Zip Code
19. Phone Number
21. Please SUBMIT YOUR QUESTION
23. Disclaimer:
    Information submitted on this form will be sent via email. To protect sensitive information, do not send the following information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, medical information, passport numbers, and passwords. This for should not be used for Open Public Records Act requests. Please visit the Clerk Page for OPRA Requests.
25. For OPRA REQUESTS
    FOR OPRA REQUESTS
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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field