Laserfiche WebLink
ORONO ADMINIS�p'T�E O�SCES � <br /> =NFpR�SATION DISCLOSIIR� �Q�ST <br /> MINNESaTA � DATp, PR�CTICES ACT <br /> gEQTTESTER N�TE= � on individuals. Af�e= y°u <br /> A, Request Frequency - Private Data <br /> the <br /> have been supplied the data ana" uf foresix montnsethereafter <br /> data need not be disclosed to y <br /> unless a dispute or action is pending or additional data -on <br /> yvu has been coll.ected. zctual costs in making, <br /> g. you may be reauir�d to p�Y <br /> certif ying and%or compi ling t'r.e copies or inf ormation <br /> requested. � �� �� � <br /> Date of Re�uest: <br /> . �Z-- ��'� <br /> Requester Name: G��� <br /> A.aaress: <br /> ��o v�ahla I� c�ty: <br /> Z�D: SS 3 52S � aG � � <br /> (��--� .3��' Business : <br /> gam,e phone: l f�- � <br /> Description of Information Reauested: <br /> Re�uester` s Si9�nature: <br /> B�OW INgOgMp,T=pN TO BE FII.LED IN BY DEPAR`I^�`I' O�Y <br /> �� -Z Handled BY= <br /> Departme.nt: �.��• <br /> Mai? Phone <br /> r.� persan — <br /> Fte�uest TyPe= " -`- <br /> Not Subject of Data <br /> RecTuested BY: — <br /> Subje�� or Data �_ <br /> �_,�;�Z_c _private <br /> Info�ation Requested is Classified= <br /> �ub1;c =rotected Non-PuD1ic <br /> Confidential _Non-- <br /> Denied Aporoved in Part <br /> g�ues� is: �ADp roved __ <br /> Remarks/Ca�ments: <br /> ! <br /> Authori.ze3 Signature: � <br /> � _ $ <br /> x Total Due <br /> Fe�s= No. ot Pages Rate per Page �- <br />