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Forms Can Be Submitted via Email to lmccon r ,t fwappingerny,gov or
grobinson ,townofwappin erny.goy or in person/via mail to 20 Middlefb�us�h Rd Wappingers Falls, NY 12590
APR 0 3 2024P`",�J
FOR INTERNAL USE L Orl/appit-igWWN OF WAPPINGER
Town OerkApplication for Public Access to Records
Received by: Joseph P. Paoloni l ( �r IL REO VEST
Lori cConologue -1 EX AVIE�(,
Grace Robinson F.F,
Date Received:
FOIL Ser.
DEPARTMENT:
ASSESSOR ❑
ACCOUNTING
D
CODE ENFORCEMENT
Fq
HIGHWAY
El
RECEIVER OF TAXES
EJ
RECREATION
❑
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER E]
TOWi*l ENGINEER
TOWN ATTORNEY
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
Date FOIL fulfilled or denied:l /
Closed by:
Date:
Notes: i ewe - f
Amount Due: ._-. Pages for a total of
Marne: A.- check here if you are
Address: requesting that the records
Y) qz.0 be mailed to this address.
Agency or firm: ,, r
Telephone j✓) FAX #�: } -
Email address:.
SPECIFIC DESCRIPTION OF RECORD:
t l
. r
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.
1 request that the records be sent via e-mail to the address fasted. above
I request that the records be faxed to the number listed above