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Forms Can Be Submitted via Email to lmeconologuegtownofwappingerny.gov or
grobinson(dtownofwappingerny.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni ❑
Lori McConologue ❑
Grace Robinson ❑
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Date Received: 1
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
❑
CODE ENFORCEMENT
HIGHWAY
❑
RECEIVER OF TAXES
❑
RECREATION
❑
SUPERVISOR
❑
TOWN CLERK
❑
WATER/SEWER
❑
DOG CONTROL OFFICER ❑
TOWN ENGINEER
❑
TOWN ATTORNEY
❑
Name:
Address:
TOWN OF WAPPMGER
Application for Public Access to Records
FOIL .REO UEST
FOR DEPARTMENT USE ONLY
Date Received by Dept W /
Department Head approval;
snit)
Date Applicant Contacted: Leal & 127
Date FOIL fulfilled or denied: L2 / 6 /3
Closed by: Mia6zzl_
Date: 1 I
d
Notes: V� E?"'e_
G
Amount Due: ---- Pages for a total of $
Agency or firm:
Telephone #: ( I)0 FAX #: ( } -
Email address:
❑check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF ORD: r
keol (f
FO � AT OF RECORD (if available)
I request to be notified when I can come to inspect the record(s) described above
rI 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