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Forms Can Be Submitted via Email to lmcconol ueCa)townof_ aamiRgeri or
gsobinson cc7towngfwappingerny.grov or in g &issordvia snail to 20 ivliddlebush }fid Wappingers Falls, NY 12590
FOR.. INTERNAL USE ONLY
Received by: Joseph. P. Paoloni CJ
Lori IvlcConologue
Grace Robinson [ l
Date Received:
FOIL ,Ser. #:
DEPARTMENT:
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
IHrequest to be notified when I can come to inspect the record(s) described above
HIGHWAY
RECEIVER OF TAXES
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RECREATION
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SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER ❑
TOWN ENGINEER
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TOWN ATTORNEY
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TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REO VEST
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Date Received by Dept /
Department Head approval:
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Date Applicant Contacted: / c /
Date FOIL fulfilled or denied:
Closed by:
Date:
Notes:
Amount Due: `---Pages for a total of
Name:,' check here if you are
Address: C` l requesting that the records
P) N ' � `� 6be mailed to this address.
Agency or firm: e, X - !L C ori N r� 0 0/
Telephone #: (q4. ) 2 FAX #: ( )
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SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
IHrequest 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 tee schedule on the back of this application
I request that the records be sent via e-mail to the address listed above