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Forms Can Be Submitted via Email to Imcconologue0ctownofwappingern y.go or
gLobinson@ ownofwaRLinern Eov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
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FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni F1
Lori McConol0gUe Ar
Grace Robinson El
Date Received; / /
FOIL Ser. Pt: Ao;)-4
DEPARTMENT:
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
HIGHWAY
0
RECEIVER OF TAXES
0
RECREATION
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SUPERVISOR
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TOWN CLERK
accordance with the fee schedule on the back of this application
I listed
WATER/SEWER
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DOG CONTROL OFFICER
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TOWN ENGINEER
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TOWN ATTORNEY
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IMM116 MA =��So
Application for Public Access to Records
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Buddhig t)epartmant
TOWN 0j, WAPPINGER
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
offlt)o
Date FOI(ulfilled r denied:
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Closed by: fiLluu,
Date:
Notes;
Amount Due: _ Pages for a total of $
Name: Rabe,, Av6z,( F -]check here if you are
Address: C --T- requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: ('8 4 5 ) 191. 6110 FAX 4:
Email address: r" .4.r -r, &,, 1Z 6 m A , C 0,?Vl
SPEC FIC DESCR,IPTIONg:CORD:
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FORMAT OF RECORD (if available)
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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
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accordance with the fee schedule on the back of this application
I listed
request that the records be sent via e-mail to the address above
1 request that the records be faxed to the number listed above