Putnam County
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e. TOWN OF WAPPINGER 537 4 0
. 'GENERAL DISBURSEMENT ACCOUNT BankofAmerica. ..s...
. _ 20 MIDDLEBUSH ROAD, P.O. BOX 324 ~- NUMBER
WAPPINGERS FALLS, NY 12590-0324
. 29-1/213 53740
Fifteen and 00/100 Dollars
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AUTHORIZED SIGNATURE
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PAY
TO THE
ORDER
OF
DATE
AMOUNT
11/21/2005
****15.00
PUTNAM COUNTY
110 OLD ROUTE 6 BUILDING
CARMEL, NY 10512
II' 0 5 ~ 7 ~ 0 II' I: 0 2 . ~ 0 0 0 . ~ I: ~ ~ 7 5 b ~ b ~ ~ ~ III
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OSC TELECONFERENCE REGISTRATION
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I NAME: '" QH~ 15 fl1A.STE.~of\
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I MUNICIPALITY: -ro-z1>ri &P (A>(tPr7IIJ6E-tl-.
I ADDRESS: :20 fY1l0bl-5JJOSU /(15
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I PHONE: (8'f.s) ~'t 7 ... 5 t"J1( FAX: (8"ll5) Jq 8- - ILf'78"
I TELECONFERENCE SITE SEl.ECTED:
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"""Pii'il\ll~ndaY,December 12, 2005
$15.00~erp~..~onPAYABLE TO THE SITE OFYOUR CHOICE
TITLE:
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E-MAIL: "1(1)011 o~ wlfPPoJ6Ef<. tJ S
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Please register early-- Sites reserve the right to cancel their partie
is insufficient registration. Notify the site if you require any specia
RETURN THIS FORM&CHECK directly to the SITE you he
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* NOTE: Pursuant to General Municipal Law S77-b, certain expenses incurred in connection with attendance at this telecol
municipal charge if attendance is authorized in advance by the governing board, or, in certain instances, appropriate exeCl1
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