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Forms Can Be Submitted via Email to lmcconotogue(c,townofwwappingerny.gov or
grobinson Zctownofwappinl erny.t;oy or in person/via snail to 217 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paolon:i
Dori McConologue
Grace Robinson E,
Date Received: 1 l
r
FOIL Ser. #: 9
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
❑
CODE ENFORCEMENT
be mailed to this address.
HIGHWAY
RECEIVER OF TAXES
❑
RECREATION
SUPERVISOR
❑
`TOWN CLERK.
D
WATER/SEWER
�s
DOG CONTROL OFFICER ❑
TOWN ENGINEER
❑
TOWN ATTORNEY
El
TOWN OF 'APPA' GER.
ication for Public Access to Records
FOIA REQUEST"
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
(ink)
Date Applicant Contacted: 4 T 0 5'
.
Date FOIL fulfilled or denied.: /,?7/ `j
Closed by: __._
Date:
/-7/
Notes:
- e 4
A.xnount Due: Pages for a total
Name: ' -7 J"' !
-]cheek here if you are
Address: '.
requesting that the records
T
be mailed to this address.
Agency or firm:
Telephone #: ( 27) - FAX
Email address: r
'7
SPECIFIC DES RIPT'ION OF RECORD:
5
�s
FORMAT OF RECORD (if available)j'}/J�,
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
I request that the records be faxed to the number listed above