Rose, Susan M. Csara e Sale MIA
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R ^ Town of Wapp
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Name: Zf asrj
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Address: � �
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W ingaers Falls NY 12590
(City) (ST) (zip)
Phone: (11� k91 - � 7?k.
Address of Sale: � 1 L
(If different from above) (street adds)
Wappingers halls NY 12590
(city) (ST) (Z
Date of Sale: "r �� From: / Lj (at /pm) until (am/W))
(Tim
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Sign: Date:
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni ❑
Grace Robinson ❑
Date Received: I I
Serial #:
10- 1ECLET V LSD
AUG 2 8 2019
TOWN OF WAPPINGER