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Forms Can Be Submitted via. Email to grobinsontbtownofwqppingerny.gov or
in person/via mail to til Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE OTffteived
Received by: Joseph P. PaoloniAPR 1 20
Grace Robinson
Town cit Wappin
Town Clerk
Date Received:. / %/�„,
FOIL Ser. ##: �i�
DEPARTMENT:
ASSESSOR
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ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
❑
RECEIVER OF TAXES
❑
RECREATION
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SUPERVISOR
❑
TOWN CLERK.
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WATER/SEWER
❑
DOG CONTROL OFFICER ❑
TOWN ENGINEER
TOWN ATTORNEY
❑
Name:
Address:
i -ion f6t Public Access to Records
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TOW OFW�PPINGER
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FOR DEPARTMENT USE ONLY
Date Received by Dept —31 a ''
Department Head approval:
r
Date Applicant Contacted: � /31 1 td -C,
Date FOI fulfilled or denied:
Closed by:
Date:,
Notes: f _ .. let- Il 01 p a-- glu s
Amount Due: Pages for a total of S_
Agency or firm:
Telephone #: FAX #-, ) _
Email address: i° k- P Cl.l
❑ check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD if available,3 -w / .
H1request 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