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Forms Can Be Submitted via Email to grobinsonLatownofwappingemy.gov or
in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paolom
Grace Robinson
Date Received
FOIL Ser. #:
DEPARTMENT:
'ASSESSOR
ACCOUNTING
.,CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
El
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
Name:
Address:
Agency or firm:
Telephone #:
Email address:
TOWN OF WAPINGER
Application for Public Access to ecords
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1 0 8 RE'D
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BuMing Departme
Town of Wappinge L
DEPARTMENT USE ONLY
Date Received by Dept 49 1
Department Head approval:
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Date Applicant Contacted:
Date FOI fulfilled o denied:
Closed by:
Date:
Notes: h &x d ccW. rn
Amount Due: — Pages for� a total of S
FAX
[]check here if you are
/ requesting that the records
A)v � be mailed to this address.
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SPE f ICDE SCRIPT ION "-OF RECOT
FORMAT OF RECORD (if available) q7 S,3,
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