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Forms Can Be Submitted via. Email to grobinson (&,townotWapping erny. gov or
in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
Received
FOR INTERNAL USE ONLY
APR 2 1
Received by: Joseph P. Paolo i I.��
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Grace Robinson ,nleaYv n
Date Received:
FOIL Ser. #: —°
DEPARTMENT:
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
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HIGHWAY
Date FOIL fulfilled or denied: / /
Closed by:
RECEIVER OF TAXES
❑
/ / "i-6—
RECREATION
I request copies of the records described above and agree to pay the cost of such records in
SUPERVISOR
❑
TOWN CLERK
❑
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
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TOWN ATTORNEY
❑
TOWN OF WAPPINGER
Application for Public Access to Records
L DEQ UEaT
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
init)
Date Applicant Contacted:
Date FOIL fulfilled or denied: / /
Closed by:
FORMAT OF RECORD (if available)
Date:
/ / "i-6—
Notes: I -C L2(- C/ k 1 __e
Amount Due: Pages for a total of $
Name: °r" - ® check here if you are
Address: requesting that the records
be mailed to this address.
Agency or firm:
Telephone ##: ") �' -ry , FAX
Email address:
SPECIFIC DESCRIPTIO (, 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
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