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Forms Can Be Submitted via. Email to Imcconolo ue townofwa in ei-n ov or
rabinsan cc7towraofwaLiein. �ov or in person/via email to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paol.oni 1
Lori McConologue
Grace Robinson E
Date Received:
FOIL Ser, #:
DEPARTMENT:
:
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ASSESSOR
❑
ACCOUNTr NG
CODE ENFORCEMENT
HIGHWAY
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RECEIVER OF TAXES
RECREATION
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SUPERVISOR
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TOWN CLERK.
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WATER/SEWER
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DOG CONTROL OFFICER [�
TOWN ENGINEER
❑
TOWN ATTORNEY]
Name:.
Address.
Agency or firm:.
Telephone #:
Email address: h
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TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Date Received by Dept.
Department Head approval
Date Applicant Contacted
USE ONLY
Date FOIL f ilfilled or denied: 0 / L /
Closed by:
Date:
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Notes: re– td' e L,(, rf le- t ) o
Amount Due: Pages for a total of $ —
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requesting that the records
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-;' FAX #: ( )
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SPECIE DESCRIPTION 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
I request that the records be sent via c -mail to the address listed above
I request that the records be faxed to the number listed above