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Forms Can Be Submitted via Email to l ncconoloffLue(c townofwappingerny.gov or
grobinsontowr7ofwalapin envy.fav or in person/via mail to 20 Middlebush Rd Wappingers Falls, TAY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni.
Lori 1McConologue
Grace Robinson
tc,(z�ive(TOWN OF WAPPINGER
Application for Public Access to Records
\iv 2 9 20 FOIL REQUEST
Date Received:
FOIL Ser. #:`�
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
O
RECREATION
SUPERVISOR
TOWN CLERK,
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
D
TOWN ATTORNEY
w
FOR DEPARTMENT USE ONLY
Date Received by Dept p ,_2p �2_
Department Plead approval:
(init)
Date Applicant Contacted: p 211 2�_
Date FOIL fulfilled or denied:
Closed by:
Date:
Notes:
Amount Due: Pages for a total of,$
Name: Vit' i i check here if you are
Address: I��nl requesting that the records
be mailed to this address.
Agency or firm:r J7 P19-71
,.
Telephone #: ( ) - FAX ##:
mail address: I rl (ir" c Y4.
SPECIF C DESCRIPTION OF RECORD:
V°C' c30
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FORMAT OF RECORD (if available)
LNJ 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
E] i request that the records be faxed to the number listed above