Town House	179 Westchester Avenue	Pound Ridge, New York 10576-1743

Town of Pound Ridge
	Tel.: 914-764-5511 Fax: 914-764-0102	

FREEDOM OF INFORMATION LAW
PUBLIC ACCESS TO RECORDS 
Name:	 Address: Phone:
I hereby request the Town Clerk or Deputy Town Clerk of the Town of Pound Ridge to produce for my inspection, review and/or copy the following:
(Describe the specific file, document(s), report(s) or other requested materials)
I understand that a charge of S.25 per page will be charged for copies Fee paid: S
Applicant's Signature:
Authorized by:	
(Records .Access Officer) Date: