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2024-176Click I-Icre To Search Our Public Records Database Before Submitting Request Forms Can Be Submitted via Email to Imeconolof ueCc townofwappingerny. ov or grobinson(cDtownofwa pingerny.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590 FOR INTERNAL USE ONLY Received by: Josepb P. Paoloni I Lori McConologue Grace Robinson P Date Received: _ / l FOIL Ser. #: ' W `7 DEPARTMENT: ASSESSOR] ACCOUNTING El CODE ENFORCEMENT HIGHWAY 0 RECEIVER OF TAXES El RECREATION 11 SUPERVISOR El TOWN CLERK 1-1 WATER/SEWER DOG CONTROL OFFICER 7 TOWN ENGINEER 11 TOWN ATTORNEY 11 Name: Address: Agency or firm:_ Telephone : Email address: TOWN OF WAPPINGE Application for Public Access to Records e FOIL REQ C � d a ec ~� 7 [jrr,J llllq► — u tori r)e1marnant TOWN OF 1ot _.. „ _ .WAPPm FOR DEPARTMENT USE. ONLY Date Received by Dept t I r Department Head approval: (ant) Date Applicant Contacted: Date FOI fulfilled or denied: Closed by: a ° Date: Notes: Amount Due: __ Pages a total of $ []check here if you are y requesting that the records be mailed to this address. f A FAX #: ) _ LIS SPFCIFIC DESCRIPTION OF RECORD: FORMAT OF RECORD (if available)- "TMS 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 0 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