Dutchess County, NY · Dutchess County
Consecutive Agreement Information for Public Water Systems That Purchase Water
This form records information about public water systems that purchase water and the services, sampling responsibilities, and agreements between the seller and purchaser.
At a glance
- Issued by
- City of Dutchess County · Dutchess County, Dutchess County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- dutchessny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Public water systems that purchase water use this form to document information about the seller and purchaser systems and their relationship. It asks for system identifiers, populations, water source, treatments, services provided, and details about sampling requirements and agreements. The completed information is included in the permanent file for the systems listed.
Who needs it
Public water systems that purchase water complete this form to record information about their systems and the seller-purchaser relationship.
How to submit it
Submit it to the county department named on the form; check the county website for current contact details.
About notarization
This document is signed and dated without a notary; it does not identify any attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download the Form
Download the Consecutive Agreement Information form for public water systems that purchase water.
- 2
Complete the System Information
Enter the seller and purchaser system details, services provided, and sampling information to the best of your ability.
- 3
Gather Agreement Information
Indicate whether a consecutive agreement or other documentation is available and attached, and explain sampling arrangements where requested.
- 4
Submit the Form
Submit it to the county department named on the form; check the county website for current contact details.
Frequently asked questions
- Do I need a notary for the Consecutive Agreement Information form?
- No. The form asks the person completing it to provide a name, title, and date; it does not require notarization or identify a sworn attachment.
- Who completes this water system information form?
- The form is for public water systems that purchase water. It records details about the seller and purchaser systems and the services and sampling responsibilities between them.
- What information does the form ask for?
- It asks for system names and identifiers, populations, source of supply, treatments, services provided, sampling requirements, and information about any consecutive agreement or other documentation.
- How do I submit the Consecutive Agreement Information form?
- Submit it to the county department named on the form; check the county website for current contact details.