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Forms Can Be Submitted via Email to lmcconoloSuetownofwa in ern ov or
grobinson Utownof,�vappingerny. ov or in Person/via mail to 20 Middlebush. Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lori McConologue
Grace Robinson F
Date Received:
FOIL Ser. #: _
DEPARTMENT:
ASSESSOR
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ACCOUNTING
El
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
El
RECREATION
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SUPERVISOR
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TOWN CLERK:
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
El
TOWN ATTORNEY
TOWN OF WAPPINGER
tion for Public .Access to Records
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app' W
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
(snit)
Date FOIL fulfilled or denied: / 2 -
Closed by:
Date: f 21 /
Notes, Co Gni eo t Yq4t 16vd 014
Amount. Due:
total of $
Name: �..` c ®cheek here if you are
Address: �/ ,�g .,,-p requesting that the records
_VAA' be mailed to this address.
Agency or firm.
Telephone #: FAX #: ( ) -
Email address: e— , , -T- A 4 IN
SPECIFIC DESCRIPTION OF
1
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 e-mail to the address listed above
I request that the records be faxed to the number listed above