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Forms Can Be Submitted via Email to Imeconotogue(-&,fownofWappinget-,tiy.gov or
or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 0
Lori McConologue V
Grace Robinson 0
Date Received
FOIL Ser, #:
DEPARTMENT:
ASSESSOR
El
ACCOUNTING
11
CODE ENFORCEMENT
E]
HIGHWAY
El
RECEIVER OF TAXES
Closed by:
RECREATION
SUPERVISOR
F-1
TOWN CLERK
Notes:
WATERJSEWER
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
TOWN OF WAPPINGER
Appli ation for Public Access to Records
�el&qe' FOIL REO UEST
FOR DEPARTMENT USE ONLY
Date Received by Dept
lH '44
Department Head approval:
(init)
Date Applicant Contacted:
Date (TI, f_u 11 d or denied:
Closed by:
at 0
Date:
Notes:
Amount Due: ,— _Pages for a total of $
Name: 'L Mck rt-' ®check here if you are
Address: requesting that the records
.61be mailed to this address.
Agency or firm.
Telephone #: (Sy5
FAX
Email address:
SPECIFIC DESCRIPTION OF RECORD:
FORMAT 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
F1 I request that the records be sent via e-mail to the address listed above
E] I request that the records be faxed to the number listed above