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Forms Can Be Submitted via Email to �Imccono,_gi[eIo Q
_Li,,townofwappingcrqy.goy or
grobinson Lc6jownof%v{jpp.uige
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FOR INTERNAL USE ONLY
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Received by: Joseph P. Paotoni J� Fo vv
Lori McConologue
Grace Robinson
Date Received:
FOIL Ser. #: �
DEPARTMENT:
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
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HIGHWAY
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RECEIVER OF TAXES
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RECREATION
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SUPERVISOR
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TOWN CLERK
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DOG CONTROL OFFICER F-1
TOWN ENGINEER El
TOWN ATTORNEY 1:1
Name:
Address:
Received
APR 2 1 GTOWN OF WAPPINGER
A5
pplication for Public Access to Records
P P i n g 60IL RE T
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
di )6-
Date FO fulfilled r denied: /
39
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Closed by:
Date: y A / C36)s_
Notes:
6
Amount Due. _ Pages for a total of $
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®check here if you are
requesting that the records
f be mailed to this address.
Agency or firm:
Telephone #: 0's4� - AX
Email address: 4Q
SPECIFIC DESCRIPTION OF RECORD:
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FOR -MAT 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
ElI request that the records be sent via e-mail to the address listed above