HomeMy WebLinkAboutRequest''Village of Capuga 3beigbu;
MARCHAM HALL
836 HANSHAW ROAD
rrHACA, NEW YORK 14850
(607)257-1238
fax(607)257-4810
REQUEST FORM
FREEDOM OF INFORMATION ACT
Date: 21 � Lp
Name of Requester; , -(-Ly�,YLO�4Lk 0_b Sf_.W-Q- f&Vj �-"LKOOL-rl
Email Address: d-LA�Yut0.i4� t-ana-I a In t n . t S 0,C V, ' Ln—/P
Daytime Phone: x-61— 213 - Zia Z
Mailing Address:
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Dear FOIA Officer: PM 0�-cr`I A -'j
This is a request for information filed under the Freedom of Information Act.
I wish to inspect the following records:
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equestor's signature
Mail this form to the address above or email to clerk(rdcavuea-heiehts.nv.us