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Forms Can Be Submitted via Email to ltncconolo9LIeCC townofwappingerny.g;ov or
robinson LL)townofwappingc av or in person/via mail to 20 Middlebt:ush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni I
Lori McConologue
Grace Robinson F
Date Received:
FOIL Ser, :
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ASSESSOR
ACCOUNTING
❑
CODE ENFORCEMENT
HIGHWAY
❑
RECEIVER OF TAXES
RECREATION
❑
SUPERVISOR
❑
TOWN CLERK
❑
WATER/SEWER
FAX # (
DOG CONTROL OFFICER
TOWN ENGINEERI
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TOWN ATTORNEY
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TOWN OF WAPPII' GER
Application for Public Access to Records
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FOR DEPARTMENT USE ONLY
Date Received by Dept /0In
Department Head approval:
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Date Applicant Contacted:
Date FOIL fulfiller) or denied:
Closed by:
Date:
Notes:
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Amount Pages for a total of ---
Name:
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Address:,'3
requesting that the records
be mailed to this address.
Agency or firm:
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Telephone #: (req
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FAX # (
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Email address:
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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 cast of such records in
0
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