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Forms Can Be Submitted via Email to ImeconologuctownofwEpingerny.gov or
obinson townofwa in ern ov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni ❑
Lori McConologue ❑
Grace Robinson ❑
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
❑
CODE ENFORCEMENT
ED
HIGHWAY
RECEIVER OF TAXES
RECREATION
❑
SUPERVISOR
CI
TOWN CLERK
11
WATER/SEWER
❑
DOG CONTROL OFFICER El
TOWN ENGINEER
TOWN ATTORNEY
❑
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received
MAR 2 3 2026
Town of Wapp�nger
Town CIerk
FOR DEPARTMENT USE ONLY
Date Received by Dept 1l
Department Head approval:
(init)
Date Applicant Contacted: IA 1 a�
Date FOIL fulfilled or denied:, 1 I
Closed by:
Date:
Notes: U,
wt Due: -U - Pages for a t tal of $-
Name: via ta \11aU ❑check here if you are
Address: ]';I—o) ; T j i@ , -4 requesting that the records
)-1 IAS ; 0 �� � be mailed to this address.
Agency or firm:
Telephone #: ( } -�� FAX #: ( ) -
Email address:' ' dirl C yyL
SPECIFIC D TION OF RECORD:
T' � q %o (20
c
FORMAT OF RECORD (if available)
IH
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 re,
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