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Forms Can Be Submitted via Email to lmcconol 7 i appingerny.gov or
robinson(c�townrn
ofwappin ey.gov or in via snail to 20 Middlebush Rd Wappingers Falls, NY 12.590
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FOR INTERNAL USE..QM n of VV a p p i njQkWNOF WAPPINGER
1Clerkkpplication for Public Access to Records
Received by: Joseph P. Paoloni � REQUEST
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Lori McConologue'r.
Grace Robinson -
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Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
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RECEIVER OF TAXES
❑
RECREATION
❑
SUPERVISOR
I request that the records be sent via e-mail to the address listed above
TOWN CLERK
❑
WATER/SEWER]
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
❑
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-row,, of VVappinger
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
. its
Date Applicant Contacted: ` / /
Date FOIL fulfilled or denied: lc97/
Closed by:
Date:
Notes:
Amount Due: Pages for a total of $
Name: Ee Mp ]check here if you are
Address: requesting that the records
/,-,2 be mailed to this address.
Agency or firm: . L
Telephone ( tr L, FAX #: ( }
Email address:. Vr -x. ite-,.. c & wNA
SPECIFIC DESCRIPTION OF RECORD:
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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
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