Croswell, Roz I
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Garage Sr� App i1 .do
Return�: Town Cler.
"dawn cad a pinger
N 20 Middl Rd,
W ppin er Falls, NY 12590
Name. j
(IMO M) f
Address:
(street XwMils
Wappi
ink ';alls,JSY 12590
Pt ') 01) EMAP)
Phone. 94�j +
.Address of Sale: f111 I+
(if different from ,above)
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Date of le; l m until (am/0
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Sign. Date: QI2- �
Received by, Joseph . Paalanl
Grace Robinson
Date Received; _ 9 E V In
IE Q7I
Serial OCT 12 2017
T VVIR OF WAPPINGER
TOWN CLERK
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