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Forms Can Be Submitted via Ernail to lmcconotOgLie�townofwappingerny.gov or
grobinson OctownofwappingLi.:E�.ov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lori McConolOgUC
Grace Robinson F7,
Date Received: /_/_ 1�-Y-
FOIL Ser. #: P ruq7!�
DEPARTMENT:
ASSESSOR
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ACCOUNTING
Address: v requesting that the records
CODE ENFORCEMENT
be mailed to this address.
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RECEIVER OF TAXES
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RECREATION
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SUPERVISOR
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TOWN CLERK
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TOWN ATTORNEY
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Application for Public Access to Records
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Date Received by Dept
Department Head approval:
Date Applicant Contacted:
Date FOIL fulfilled or denied:
Closed by:,
Date:
Notes:.
Amount Due: ' Pages for a total of $—.--
Name: 't [check here if you .are
Address: v requesting that the records
be mailed to this address.
Agency or firm: 1
Telephone 0,)) FAX
Email address:
SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available)
Irequest to be notified when I can come to inspect the record(s) described above
1 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
F-1
I request that the records be faxed to the number listed above