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Administrative Penalty Notification Form

Submit the form below.
  • You may save this form and return to it later by clicking "SAVE & CONTINUE" at the end of this form.
  • A copy of the completed form will be sent to the email address in the Contact Information section.

To pay your MassDEP Invoice online with Credit Card or ACH payment, please visit MassPays.

If you have any questions, email dep.admp@mass.gov  
OR call our helpline: 1-800-248-1645

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