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Fon-ns Can Be Submitted via Email to linccoeolo ue a�to-�vnofwa in ern , ov or
grobinson.(tr�,townof,Arappingerny.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P, Paoloni E
Lori McConologue-
Grace Robinson J
Date Received: / 1
FOIL Ser. 9: 5 --�
DEPARTMENT:
ASSESSOR ❑
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY ❑
RECEIVER OF TAXES ❑
RECREATION ❑
SUPERVISOR ❑
TOWN CLERK
WATER/SEWER ❑
DOG CONTROL OFFICER El
TOWN ENGINEER ❑
TOWN ATTORNEY ❑
TOWN OF WAPPINGER
Application for Public Access to Records
F�lL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
x/26/ 25
6�
(ir►it)
f Z / 262.5
Date FOIL fulfilled or denied: q-
Closed by:
Date,
Notes: e 4.61
Amount Due: -_- Pages for a total of $
Name: ( )Q ��,P,� ❑check here if you are
Address: _ �3 ' ] Y' requesting that the records
WaV 4061 be mailed to this address.
Agency or firm:
Telephone #: (q1.4 5A FAX #: { ) -
Email address: ei610thIMA-i i • eOYA
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SP IFIC DESC TION OF RE
VeAA t�u& oi— >3�At;t
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