1999
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REQUEST FOR COpy OF RECORD IN' THE CUSTODY OF
THE TOWN OF WAPPINGER
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Description of
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Record requested W 1 ,,-{' '01\ ~ R. k Li Lb<..K."1 LI ~ -
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Name of Department or file in which record may be found
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Date of Record c.J (1, \;\ rJ.p ./ 7 J C; 7 )'
Number of Pages to Qe copied
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Fee
Address
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Name of Requestor
Tel. No.
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Date of Request
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HEI'llESENrnlt . (
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HAlLIn:: ADDRESS
r::: ~ FOR AGENCY USE ONLY
~~~ED~r the reason(s) checked below)
Confidential Disclosure Part of Investigatory Files
Unwarranted Invasion of Personal Privacy
Record of Which this Agcncy in Legal Custodian cannot be fOIDld
Record io llot Maintained by this Agency
Exem d by Sta' 'C Other thon thc Frecuom
r (Specify ,-
NOTICE: Requeots for appealn :;hol1 be moue to Records Accesn Officer, City Chamberlain,
'Who muot fully explain reasons for :;uch denial in writing seven days after
receipt of an appeal. All appeals will be heard by Hearing Officer.
I HEREBY APPEAL:
DA'l'E
SIGllA'l'UHE
ALL APPEALS WILL DE FILED rlI'l1l:
state of New Yorlt
Committec on Public Acceos
Department of state
162 Wanhington Avenue
Albany, New York 1~231
to Records
FEE SCHEDULE:
(a) There ohall be no fee charged for:
6 roo sh.ll b.
charGco for
(1) inspection of recordsj
(2) search for recordsj or
(J) any certification pursuant to this part
COPicn~.~ '0:; 03 followo: .
(1) .25i per page for copien
Transcript of recordo- Typed or
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