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Forms Can Be Submitted via Email to jmcconologucgtownofwP.
2: ingenlygov
. or
grobinsoii@,townofwappiLigemy.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 11
Lori McConologue P-'
Grace Robinson El
Date Received:
FOIL Ser. #:
DEPARTMLENT:
ASSESSOR
11
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
RECREATION
0
SUPERVISOR
F-1
TOWN CLERK
El
WATER/SEWER
F�
DOG CONTROL OFFICER 0
TOWN ENGINEER
El
TOWN ATTORNEY
7
Name:
Address:
Agency or firm:_
Telephone 4: ( 91
Email address:
SPECIFIC DESCRIPTION OF RECORD:
A plication for Public Access to Records
er'e:j\A FOIL RE ST
ED EC';o
ot �nge, 01 17
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"TOAN S r;
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted: c)+-
Date
)j-
Date FOIL ilfilled denied: 161
Closed by:
Date:
Notes:
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Amount *Due: Paggesq�or a total of $
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F1 check here if you are
requesting that the records
be mailed to this address,
FORMAT OF RECORD (if available)
IH request to be notified when I can come to inspect the record(s) 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
F� I request that the records be faxed to the number listed above