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Forms Can Be Submitted via Email to grobiiisoji(-dtownofwappingei-ny.go or
in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
F
Received
FOR INTERNAL USE ONLY
APR 2 1 2026
Received by: Joseph P. Pate of Wa� pinget
Grace RobinsorTT-own Clerk
Date Received:
FOIL Ser. #: io "—
DEPARTMENT:
ASSESSOR
El
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
❑
RECEIVER OF TAXES
D
RECREATION
❑
SUPERVISOR
❑
TOWN CLERK
El
WATER/SEWER
❑
DOG CONTROL OFFICER [I
TOWN ENGINEER
0
TOWN ATTORNEY
7
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Public Access to Records
. REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval
Date Applicant Contacted:
Date FOIL(tlf_T�o denied:
Closed by:
WM
Notes:
Amount Dut: Pages for a total of $
Name: Not eV, V Vou w) check here if you are
Address: ��A AAC, &:) '4a �--' requesting that the records
i6v be mailed to this address.
Agency or firm: tiefK'S IkHa4l q
Telephone 4: r5
FAX #:
Email address: hkdsm 00 Ary, 164111
SPECIFIC DE5CRIPTION OF RECORD:
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L.Cle-awA Pe,r-,ryv '.(.� 4'e? i" -
FORMAT OF RECORD (if available) &')
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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
F� I request that the records be faxed to the number listed above