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Forms Can Be Submitted via Email to ltncconologLieL6townofwappingemy.gov or
grobinsonRqtownofwappingernygov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni F1
Lori McConologue F1
Grace Robinson U
Date Received:
FOIL Ser. #-.
DEPARTMENT:
ASSESSOR
El
ACCOUNTING
CGDE ENFORCEMENT
L,•'"-1
HIGHWAY
F-1
RECEIVER OF TAXES
0
RECREATION
E]
SUPERVISOR
F-1
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
'TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REOUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept IC) /
Department Head approval: tp
JC) q--7
Date Applicant Contacted:
Date FOIL fulfilled or denied: 3
Closed by:
Date: _112
Notes:
Amount Due: --. Pages for a total of $ —
Name: 'ryl 0
Address: 1f,t( -0f,i
�10
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Agency or firm:
Telephone #:
" j6tLf7
Email address: /v" [I"/) >: jl� ream
FAX #:
SPECIFIC DESCRIPTION OF RECORD:
.......... . . .
Q check here if you are
requesting that the records
be mailed to this address.
FO MAT OF RECORD (if available)
I 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-1 I request that the records be faxed to the number listed above