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Forms Can Be Submitted via Email to grobinson cztownol appmZerny.Kov or
in person/via mail to 20 C'v'liddlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Grace Robinson
Date Received: /
FOIL Ser. ##: 0 __,�v
1119 MIkly ski I VON IA
ASSESSOR
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ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
❑
RECEIVER OF TAXES
❑
RECREATION
❑
SUPERVISOR
❑
TOWN CLERK
El
WATER/SEWER
❑
DOCK CONTROL OFFICER ❑
TOWN ENGINEER
❑
TOWN ATTORNEY
❑
TOWN OF WAPPfNR
eived Application for Public Access to Records
25 2026 FOIL REQUEST
U.EST
Townt Wapping r
T wn Glen
Name:
Address:Or`vc
Agency or firm:
Telephone #: ( 11
Email address:
FOR DEPARTMENT USE ONLY
Bate Received by Dept //
Department Head approval:
init)
Date Applicant Contacted:. I ` 1 0
Date FOIL fulfilled or denied: 1�2/ C9 (�'
Closed by:
Date: I/
Notes:
Amount Due: Pages for a total of
FAX #: (
❑check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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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
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 reeuest that the records be faxed to the number listed above