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TOWN OF WAPPINGER
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20 MIDDLEBUSH RD.
WAPPINGERS FALLS, NY 12590
TOWN CLERK
OFFICE: 845-297-577] -FAX: 845-298-1478
APPLICATION FOR PUBLIC ACCESS TO RECORDS
Date Request Received: ~ FOIL # df :J.....
Recorded: Chris Masterson, Town Clerk
From:
Print Name:
Agency or Firm:
Address:
Tel. #:
I hereby apply to: JV inspect the following record and/or
,~ receive a copy @ .25 cents /page if available to the public .
Description of record requested: (' j() F--1 I p Q
APPROVEDIDENIED
REVIEWED BY:
RECEIVED BY: . ;/iJ.
DATERECENED: /,-~-/CJ
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APPOINTMENT SET:
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DATE FILED:
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