Accident Report
TOWN OF WAPPINGER
SUPERVISOR
CHRISTOPHER J. COLSEY
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TOWN COUNCIL
WILLIAM H. BEALE
VINCENT BETTINA
MAUREEN McCARTHY
JOSEPH P. PAOLONI
SUPERVISOR'S OFFICE
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS, NY 12590
(845) 297-2744
FAX: (845) 297-4558
ACCIDENT REPORT
NAME
DESCRIPTION OF ACCIDENT
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DATE OF ACCIDENT._________________
TIME OF ACCIDENT-'-_________....___
PLACE OF ACCIDENT
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WITNESSES OF 'ACCIDENT_...____. __..
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DATE REPORTED TO COMPTROLLER_
SIGNED___~_
SUPERVISOR
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