Enter whatever information you can provide below, then click on the "Submit the Form" tab.
Notes:
- The nominated property must be in BROOME or TIOGA County, New York.
- Be sure to include your contact information.
- Digital photos may be submitted in jpg format by email to this address: PAST@stny.rr.com.
- Send an email with any questions, or call 607-237-0887.
Use your web browser's "Print" feature to print a copy of this form for your records.