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Forms Can Be Submitted via Email to ImcconolOgUeLkownofwappi ngSjy oy or
�robinson(cr?townof�vappiLigertiLov or in person/via mail to 20 Mi(Vbq4hrRd)�
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FOR INTERNAL USE ONLY
Received by: Joseph P, Paoloni F
Lori McConolOgUe F
Grace Robinson 7
Date Received: — / I Tow
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
0
CODE ENFORCEMENT
V
HIGHWAY
El
RECEIVER OF TAXES
0
RECREATION
F-1
SUPERVISOR
❑
TOWN CLERK
❑
WATERJSEWER
❑
DOG CONTROL OFFICERE-1
TOWN ENGINEER
❑
TOWN ATTORNEY
Name:
Address:
Agency or firm:
Telephone #: ( N
Email address: 0 11,
Falls, NY 12590
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TOWN OF WAPPINGER
�eceiM lication for Public Access to Records
FOIL REO VEST
JUL 0 1. Z024
of Wappinge
own Clerk
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
Date FOIL fulfilled or denied: 13LI-ot
Closed by:
Date:
5 ISLI'2C-1
Notes: � A Dv-il111 KnAe_ P_ Qk"s
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Amount Due: _-Z-- Pages for a total pf $
FAX #:
[]check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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17 �j
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
❑
F-1
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