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Forms Can Be Submitted via Email to Iiiiccoiiologtie((-6,towiioftvappingen7y.gov or
grobiiisoii(c-t,)townofwappin,gern v.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
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Received by: Joseph P. Paoloni
Lori McConologue
Grace Robinson F_
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
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ACCOUNTING
F�
CODE ENFORCEMENT
P"
HIGHWAY
❑
RECEIVER OF TAXES
RECREATION
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SUPERVISOR
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TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
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Name:
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I
Application for Public Access to Records
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10 '1, uiUng Departmant
OWN OF WAPPINGER
FOR DEPARTMENT USE ONLY
Date Received by Dept j"
Department Head approval:
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Date Applicant Contacted: A-0 X�y
Date FOI161�IfAled or denied:/() ITI" Al
Closed by:
Date:
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Amount Due: _ Pages for a total of $
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requesting that the records
be mailed to this address,
Agency or firm: �W C, j C I-j(7,-ra -V 'Y E-A L—j -0 _(2,9
Telephone #: FAX #:
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Email address: COM
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available) 635T- 63-0cl&6),Al�
.1 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 will 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