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Forms Can Be Submitted via Email to IMCC011010gLie r townofwappingerny.gov or
gr binson
.,towpofwappin&Ln1y,go or in person/via niail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni >�(
Lori McConologue El
Grace Robinson 11
Date Received:
FOIL Ser. in
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
El
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
TOWN OF WAPPINGER
Application for Public Access to Records
REQUEST
10
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...... FOR DEPARTMENT USE ONLY
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Date Received by Dept 9 /6
Department Head approval.
Date Applicant Contacted:
Data FOIL fulfilled or denied
Closed by:
Date:
Notes: . . .... OCkOle CC,
Amount Due: _j_ Pages for a total
heck here if you arse
, At r C nce
Address: 2- 01 A
requesting that the records
5— (C be mailed to this address.
Agency or fin-n:dyVI
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Telephone #: 2_ FAX #:
Email address: 0
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SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
I request to be notified when I can come to inspect the records) described above
I request copies of the records described above and agree to pay the cost of such records in
accordance with the fee schedule on the back of this application
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above