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Forms Can Be Submitted via Email to ImccoaIologue(r,townofwappingerny.gov or
ro'binsonL&townotwappingerny. oy or in person/via mail to 20 Middlebush Rd "Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paotoni 7
Lori McConologue /
Grace Robinson �"
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
❑
RECEIVER OF TAXES
RECREATION
❑
SUPERVISOR
El
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER C„]
TOWN ENGINEER
El
TOWN ATTORNEY
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department. Head approval:
Date Applicant Contacted: /5 /24
Date FOIL fulfilled or denied: 0)
Closed by:
Ar ..
Date:
Notes:
Amount Due: Pages for a total of $
Name: �:' ri" []check here if you are
Address: " `'. c requesting that the records
e mailed to this address.
Agency or firm:
Telephone #: (ck l } Ll "I l ,t $ FAX # ( ) -
Email address: i...6
SPECIFdIC DESVCRIPTION,QF RECORD.
Aqqy y y
-
FORMAT OF RECORD (if available)
Irequest 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
I request that the records be faxed to the number listed above