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Forms Can Be Submitted via Email to gro bin son (&,townofwappingerny. g16 or Received
in person/via nail to 20 Middlebush Rd Wappingers Falls, NY 12591
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FOR INTERNAL USE ONLY Tl t(,a,W` .PPI ' 7ER
((�
��� ._for Public Access to records
Received by: Joseph P. Paoloni ]� .
Grace Robinson I MAY 0 6 202"S �,�� �`���'"��'
Grace
Date Received: _ I����
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
El
ACCOUNTING
CODE ENFORCEMENT
"Ej
HIGHWAY
RECEIVER OF TAXES
RECREATIOIr
0
SUPERVISOR
D
TOWN CLERK:.
0
WATER/SEWER
0
DOG CONTROL OFFICER 0
TOWN ENGINEER
I request that the records be faxed to the number listed above
TOWN ATTORNEY
[]
ildijig Departinevit
Nei OF WAPPIf GER
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Dead approval:.
Date Applicant Contacted: I /
Date FOIL fulfilled or denied: /t& I 20
Closed by:
Date: 51131,96
Notes:
Amount Due: Pages for a total of $ G
Name: " rewr >a ®cheek here if you are
Address: e I , "rll c requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: � 5} 4 - " FAX #: ( -
Email address: l L,;" 'i ; "."' .1 .1` 11.0 rtlily'a
SPECIFIC DESCRIPTION OF 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 Bost of such records in.
❑
accordance with the fee schedule on the back of this application
I be Iisted
request that the records sent via e-mail to the address above
I request that the records be faxed to the number listed above