Saulnier, Kane Dara Return to: Town Clerk
Town (>l'' appincr
2{) l'ulin.1r81cbrtSh Rd.
n t T Wappingers Falls, NY 1 590
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Veel Address)
(City`) (ST)
Address of Sale: 1 Il ADri V
(if different from above) (.:trcct Yens)
Wa 1.)n„ers, Falls,NY_ 1 590
(City) {Sr) (Z'p)
Date of Sale: (sOF11From: _ (�r�� �rrl j until (ate/
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Sign Date:
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I`Qi3R INTERNAL USE. ONLY
Received by: Joseph P, Paoloni
Grace Robinson
DateReceived: J /
Serial #:
AUG 10 1017
TOWN OF WAPPINGER
TOWN CLERK