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Forms Can Be Submitted via Email to lm.cconologucgtowno fwappingemy.gov or
robinson townofwa in ern 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
Grace Robinson ❑
Date Received: 1 /
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
El
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
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RECEIVER OF TAXES
0
RECREATION
SUPERVISOR
0
TOWN CLERK
WATER/SEWER
[]
DOG CONTROL OFFICER
TOWN ENGINEER
El
TOWN ATTORNEY
El
TOWN OF WAPPINGER
Application for Public Access to Records
e.'vged FOIL REQUEST
ec
FOR DEPARTMENT USE ONLY
Date Received by Dept 1 / A
Department Head approval.
(init)
Date Applicant Contacted: 1 I( 1
Date. FOIL fulfilled or denied: //0
Closed by:
Date:
Notes:
Amount Due:
f, i f hu)
Pages for a total
Name: ��4c'
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Address:requesting that the records
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Agency or firm: Le" If
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Telephone #: ( �i - 7 F X #: ( ) -
Email address: 0 SGL f kvt-ty-1
SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available)
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
H . I request that the records be faxed to the number listed above