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Forms Can Be Submitted via Email to lnicconolo gue c towiiofwaL)j2ingemy.gov or
grobinson(clatownofwappmgerny.gov or in person/via mail to 20 Middlebush. Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni -1
Lori McConologue
Grace Robinson C
Date Received:
FOIL Ser. #: CD79
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
be mailed to this address.
CODE ENFORCEMENT
Agency or firm:
HIGHWAY
Telephone #: FAX #:
RECEIVER OF TAXES
Email address:a a`; e v '
RECREATION
❑I
SUPERVISOR
TOWN CLERK
❑
WATER/SEWER
DOG CONTROL OFFICER
FORMAT OF RECORD (if available)
TOWN ENGINEER
❑
TOWN ATTORNEY
[❑
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REOUEST
9 -
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FOR DEPARTMENT USE ONLY
Date Received by Dept / _1_� I
Department Head approval:
it)
Date Applicant Contacted: -Z /,� l
Date FOIL fulfilled or denied: / J "
Closed by:
Date:
Notes: `t'.
Amount Due: Pages for a total of $
Name: {C E] check here if you are
Address: requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: FAX #:
Email address:a a`; e v '
SPECIFIC DESCRIPTION OF pRECORD: � e
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 e-mail to the address listed above
I request that the records be faxed to the number listed above