Application for Public Access to Records

2. I hereby apply to inspect the following records:*

4. Name*

6. Representing*

7. Date
   Date

9. Mailing Address*

11. City*

12. State*

13. Zip Code*

15. Phone*

16. E-Mail*

18. Notice:
    You have a right to appeal a denial o f this application to:<br> Stephen M. Pappalardo, Village Manager, Village of Scarsdale<br> <br> <strong>Such appeal must be taken within 30 days from denial of access.

    You have a right to appeal a denial o f this application to:
    Stephen M. Pappalardo, Village Manager, Village of Scarsdale
    
    Such appeal must be taken within 30 days from denial of access.

20. Approved or Denied

    1. Approved

    1. Denied

    For reason(s) checked below:

22. 1. Are specifically exempted from disclosure by state or federal statute
    2. If disclosed would constitute an unwarranted invasion of personal privacy under the provision of the Freedom of Information Law, Section 87-2.
    3. If disclosed would impair present or imminent contract awards or collective bargaining negotiations.
    4. Are trade secrets or are maintained for the regulation of commercial enterprise which if disclosed would cause substantial injury to the subject enterprise.
    5. Are compiled for law enforcement purposes and which, if disclosed, would:

    (a) Interfere with law enforcement investigations or judicial proceedings.
    (b) Deprive a person of a right to a fair trial or impartial adjudication.
    (c) Identify a confidential source or disclose confidential information relating to a criminal investigation.
    (d) Reveal criminal investigative techniques or procedures, except routine techniques and procedures.

24. 1. If disclosed would endanger the life or safety of any person.
    2. Are inter-agency or intra-agency materials which are not:

    (a) Statistical or factual tabulations or data.
    (b) Instructions to staff that affect the public, or
    (c) Final Agency policy or determinations.
    (d) External audits, including audits by the comptroller and the federal government.

26. 1. Are examination questions or answers which are requested prior to the final administration of such codes.
    2. Are computer codes.

28. Signature

29. Title

31. Date
    Date

Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit