Hansen, William C.v °zReturn to.
Name:
(last) (Fust) (MI)
Address:'eAL �"c �° % �
(Street Address)
Wappingers Falls, NY 12590
(City) (ST) (Zip)
Phone: (S��
Address of Sale:
(If different from above) (Street Address)
Application
Town Clerk
Town of Wappinger
20 Middlebush Rd.
Wappingers Falls, NY 12590
Wappingers Falls, NY 12590
(City) (ST) (Zip)
Date of Sale: From.: a pm) until {arY>
(Day one) (Time ein) (Time End)
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/(Day Two) (Time Begin) (Tirne End)
From: (am/pm) until (am/pm)
(Day Three) (Time Begin) (Time End)
Sign:"'/._. Date: =2 t /0...3
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lynn O'Dell
Date Received.: 1 I
Serial #: