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Forms Can Be Submitted via Email to liricconologrue(ii,,towno -wapp!EEc rry.�v or
grobiii,soiik,,�townofwann'!nTern y,,,gor in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paolo,ni
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Lori McConologue L
Grace Robinson -j
Date .Received:
FOIL Ser. 9:
DEPARTMENT:
ASSESSOR
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ACCOUNTING
H-1/
CODE ENF'ORCE'MENT
HIGHWAY
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RECEIVER OF TAXES
0
RECREATION
1:1
SUPERVISOR
1:1
TOWN CLERK
1:1
WATEWSEWER
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
TOWN OF WAPPINGER
Public Access to Records
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
Date FOfulfilled � r denied
Closed by:
Date:
Notes: 91iAc
Arnount Due: _ Pages for a total of $
Name: F
—1cheek here: if you are
Address: I'li Vie 111V requesting that the records
be mailed to this address.
Agency or firm,
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Telephone 9: ri L,)IL�_ FAX
Email address: t 1,,)
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
Irequest 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 c -mail to the address listed above
I request that the records be taxed to the number listed above
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