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Forms Can Be Submitted via Email to lrncconol.Ovw"t )
�,nof%vappinTern y.gov or
,�robinsoii((-t)towtiofvappini,,erny.gov or in person/via mai tb'20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE QN
Received by: Joseph P. Paolom
Lori McConologue
Grace Robinson
Date Received:
FOIL Ser. 9.
DEPARTMENT:
ASSESSOR
CIFIC DESCRIPTION OFRECORD:
ACCOUNTING
❑
CODE ENFORCEMENT
V
HIGHWAY
C
F-1
RECEIVER OF TAXES
❑
RECREATION
❑
SUPERVISOR
TOWN CLERK
❑
WATER/SEWER
❑
DOG CONTROL OFFICERF]
TOWN ENGINEER
❑
TOWN ATTORNEY
❑
JA Ni 2 1. N"(1)%,
OWN OF WAPPINGER
1_
4cat.. lic Access to Records
QUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept _L1 -7 / 96
Department Head approval: ( Pin i 't)
Date Applicant Contacted: I /- /P&
Date FOIL fulfilled or denied: I / � /
Closed by: 94m�
Date:
Notes: f-p.4jje,ole
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Amount Due: — Pages for a total of $ —
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Narne: f'm& F-1check here if you are
Address: requesting that the records
, (V-1 be mailed to this address.
Agency or firm:
Telephone 9: SA> - I"> FAX 4:
Email address: F(�
Sp
CIFIC DESCRIPTION OFRECORD:
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C
-C)
FORMAT OF RECORD (if available)
Irequest 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
H
accordance with the fee schedule on the back of this application
Irequest 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