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Forms Can Be Submitted via Email to Im conologLte,(iDtownofwappingern y.gov
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FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 11
Lori McConologue
Grace Robinson
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
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RECEIVER OF TAXES
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RECREATION
SUPERVISOR
TOWN CLERK
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TOWN ENGINEER
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TOWN ATTORNEY
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Date Received by Dept lil7 -1
Department Head approval:
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Date Applicant Contacted: Id- rX) 3
Date FO fulfilled)r denied:
Closed by: via, i J'M� —JL
Date:
Notes:
Amount Due: _ Pages for a total of $
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Address:
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Agency or firm:
Telephone #: (Pt! L() FAX #:
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to pay the cost of such records in
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