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Forms Can Be Submitted via. Email to lrncconologuc townofwval)pin crny,go or
grobinsoric�townofuaa in er-n ov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lori McConologue " w 1
Grace Robinson
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
❑ "
HIGHWAY
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RECEIVER OF TAXES
FORMAT OF RECORD (if available)
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1 request to be notified when I can come to inspect the record(s) described above
RECREATION
I request copies of the records described above and agree to pay the Cost of such records in
SUPERVISOR
❑
TOWN CLERK
❑
WATER/SEWER
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DOG CONTROL OFFICER ❑
TOWN ENGINEER
TOWN ATTORNEY
❑
Name:
Address:
Agency or firm:
Telephone #: } -
Email address:
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TOWN OF WAPPI N ER
N 2 3 20APPlication for Public Access to .Records
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WN OF WAf PING E
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval.
Date Applicant Contacted:
Date FOIL fulfilled or denied:
Closed by:
Date:
Notes:
Amount Due: Pages for a total of $
❑check here if you are
requesting that the records
`o be mailed to this address.
FAX 4:
SPECIFIPSCRIPTION� RECORD, �
FORMAT OF RECORD (if available)
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 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