317( °licl, I leve To Search Our Public Records Database Before Submitting Request
Forms Call Be Submitted via Email toovor
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or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni I
Lori McConologue
Grace Robinson 1-1
Date Received:
FOIL 'Ser. C) "-,)- 2,
101 N V.0 N 105 1 Diem 9
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
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RECREATION
SIJPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICERE]
TOWN ENGINEER
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TOWN ATTORNEY
TOWN OF WAPPINGER
Application for Public Access to Records
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'0011
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted: C
Date FOIL fulfilled or denied: 3 /
Closed by:
Date:
Notes:
Amount Due: _ Pages for a total of $
Name: g4p
g )7jPxpfRjp lto�Ab-s E] check here if you are
Address: F6 10" 1(2-7Q requesting that the records
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Agency or firm: 4MQ H -off --5
Telephone #: FAX #:
Email address: nHfue9,fj(LmrrA9=M"'C0M
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
N—A
I Al 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
ElI request that the records be sent viae -mail to the address listed above
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I request that the records be faxed to the number listed above