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Forms Can Be Submitted via Email to grobinsonptownofwaj)pingerny.gov or
in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Grace Robinson
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
CODE ENFORCEMENT
❑
HIGHWAY
❑
RECEIVER OF TAXES
❑
RECREATION
0
SUPERVISOR
I request copies of the records described above and agree to pay the cost of such records in
TOWN CLERK
EI
WATER/SEWER
❑
DOG CONTROL OFFICER ❑
TOWN ENGINEER
TOWN ATTORNEY
❑
A
TOWN OF WAPPTNGE
Application for Public A "'. : ,„ ecori
FFR 12 2026.
�Fbwn of Wappinge
Town Clerk #
T
M 2 20( 6'
FOR DEPARTMENT USE ONLY
Date Received by Dept l l
Department Head approval: _
(init)
Date Applicant Contracted:
Date FOIL fulfilled or denied:,2,_ //,;2-
Closed
,i Closed by: _.
Date: ! l
Notes: t✓� ,
Amount Due: Pages for a total of _
Name: .dam ,+ 0 2 check here if you are
Address: V1, requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (; } J(� -,i FAX #:
Email address: jr4)AY,, 1$ o- gni c,_�4 re w v �
SPECIFIC DESCRIPTION OF RECORD:
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
be listed
I request that the records sent via e-mail to the address above
I recuest that the records be faxed to the number listed above