2024-377fling Request
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Forn-is Can Be Subirlitted via Email to Im
lmc" or
grobinson C townofwappjggcrny. or in person/via mail to 20 Middlebush Rd Wappingers Falls,, NY 12590
JPl 3 1 2M)
Received by: Joseph P, Paoloni
Lori McConologLie 7
Grace Robinson F
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
El
IZECREATION
SUPERVISOR
TOWN CLERK
El
WATER/SEWER
1:1
DOG CONTROL OFFICER F]
TOWN ENGINEER
1:1
TOWN ATTORNEY
F]
OF WAPPINGER
","Application for Public Access to Records
gt
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department head approval:
Date Applicant Contacted:
Date FOIL tulfillcdor denied: fc IPLI-.
Closed by:
Date:
Notes:
'4r
Amount Due: _ Pages for a total of
Name: Ci 4ft? n A cc vtdo 7clieck here if you are
Address: (j, 6 4- -4— )CLL) requesting that the records
'T Ls be mailed to this address.
Agency orfrrrn:._....._._' OX__T
Telephone #: �(q I ( ) 2 GF
5 FAX #-:
F.mail address: (Ita r CL C Ore�-_\_q L., -n.
.. ................
SPECIFIC DESCRIPTION OF RE COIZD:
J
-0 +
FORMAI" OF RECORD (if available)
IH 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 corse 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
1 request that the records be faxed to the number listed above