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Forms Can Be Submitted via Ernail to Imccoiiologuer-cutownofwaL)pingei-iiy,gov or
grobinson aDtownoftya in erny.gov or in person/via mail to 20 Middlcbush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paolom 0
Lori McConologue
Grace Robinson El
Date Received: / /
FOIL Ser. #: moi,D �)-q — 1 -0
I
DEPARTMENT:
ASSESSOR
F
ACCOUNTING
El
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
F1
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER ❑
TOWN ENGINEER
E]
TOWN OFWAPPINGER
AP81ication for Public Access to Records
FOIL REQ' NEST
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval.,
I (
Date Applicant Contacted: L -1J P 0q
Date FOIL fulfilled or denied: / t q / W
Closed by: 4d6w�
Date: I t
Notes: !-Qve C -CO,/ "s als-Anv'"�
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Amount Due: Pages for a total of
Name: E]chcck here if you are
Address: i requesting that the records
be mailed to this address.
Agency or firm:
Telephone S-)
FAX
Email address:
SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available)
IH 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 die fee schedule on the back of this application
Irequest that the records be sent via e-mail to the address listed above
H I requcst that the records be faxed to the number listed above