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Accountability Tag Request Form Cortland County Firefighter Personal Information Name: Date: Address: City: Zip Code: Phone: Do you have a texting plan? Yes No Do you have a smart phone? Yes No Cellphone Provider: Department Department: Date Joined: Badge Training & Certification NYS Training ID Certification: ICS: Recruit 100 Support 200 Exterior 300 Interior 400 FAST 700 800 EMT EMT Level: E-Mail Form