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Forms Can Be Submitted via Email to IrncconologLle c1,'townofwappin'gomy.goy or
grobinson cbtownofwa pingern gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 0
Lori McConologue�''
Grace Robinson �1
Date Received:
FOIL Ser. #: 1"
DEPARTMENT:
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ASSESSOR
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ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
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RECEIVER OF TAXES
RECREATION
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SUPERVISOR.
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER F
"TOWN ENGINEER
0
TOWN ATTORNEY
1-1
Name:
Address:
Agency or firm:
Telephone ##:
Email address:r
TOWN OF WAPPIFR
Application for Public Access to Records
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FOIL RE 'M
ceive6 MD
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval: v
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Date Applicant. Contacted: _�L / I / (-(
Irate FOIL fulfilled or denied: H / I— / 29
Closed by: 66��
Date:
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Notes: o'
Amount Daae: Pages for a total of S
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requesting that the records
IIs be mailed to this address.
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SPECIFIC DESCRIPTI N OF RECORD:
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FORMAT OF RECORD (if available)
I request to be notified when I can corns 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
1 request that the records be faxed to the number listed above