260
FOR INTERNAL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton ~
Sue Rose
1D-/6-/ JL
-#OJ60
Date Received:
FOIL Ser. #:
DEPARTMENT: ~
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT 0
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FOR DEPARTMENT USE ONLY
Date Received by Dept /0 / 2- / JL
Department Head approval:
(init)
Date Applicant Contacted: L 0 / 5 / 1L
Date FOIL fulfilled or denied: !O / [; / I.!.-
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Closed by:
Date:
Notes:
Amount Due: -'- Pages for a total ofS I. S"'o
Name.
Address:
Agency or firm:
Telephone #: (
Email address:
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requesting that the records
be mailed to this address.
FAX #: (
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SP~IFIC DESCRIPTIO~ OF RECORD:
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FORMAT OF RECORD (if available)
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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