156
FROM :SAMY
FAX NO. :2274291
Jul. 29 2010 12:52PM P1
Received by:
Chris Masterson 0
Christine Fulton )s::
Sue Rose 0
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONI. Y
FOIL Ser. #:
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Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
@~ORCEMENT_ i?
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FIRE INSPECTOR 'q"
ffiGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR .~
TOWN CLERK "i:1 .
WATER/SEWER '\f
DOG CONTROL OFFICER ~/
TOWN ENGINEER 'E1'
TOWN ATTORNEY' 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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(init)
. Date Applicant Contacted:
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Date FOIL fulfilled or denied:
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Closed by:
Date:
Notes:
Amount Due:
Pages for a total of S
Name:
Address:
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requesting that the records
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Telephone #: ( U') as'-
Email address: U lJ
FORMAT OF RECORD (if available)
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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
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