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Forms Can Be Submitted via Email to lnicconolo ue cAtowtiofvwappiiigerny.gov or
grobirison(ir tovwnofwappinEer'ay. ov or in persoriJvia mail to 20 Middlebush Rd Wappingers Falls, NY 12590
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Received by: Joseph P. Paoloni
Lori IvlcConologue
Grace Robinson.
Date Received: I I
FOIL Ser. : ao
DEPARTMENT:
Date Received by Dept
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
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HIGHWAY
RECEIVER OF TAXES
RECREATION
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SUPERVISOR
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TOWN CLERK
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WATER/SEWER
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DOG CONTROL OFFICER ❑'
TOWN ENGINEER
❑'
TOWN ATTORNEY
Name:
Address:.
Agency or firm:
Telephone #: �t
Email address:
TOWN OF W.APPtNGER
Application for Public Access to Records
w REO VEST
Received
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Buiwing NVWI�'M � � �7�7
TOvvn Of WaWrlge-1
)r VVappinger
FOR DEPARTMENT USE ONLY
Date Received by Dept
/
Department Head approval:
41 '
Date Applicant Contacted:
Date FOIL fulfilled or denied:
/ f:
Closed by:
Date:
Notes: P (A
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Amount Due: Pages for a total of $
. f ❑check Dere if you are
F,ax requesting that the records
C 14 � N3 " T be mailed to this address.
4 - FAX 4:
SPECIFIC IC ES RIPTION OF RECOR
"Eti s l t'^ec�w ti's
FORMAT OF RECORD (if available)" " .. -,;a
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