Laserfiche WebLink
� ORONO ADtrLTNIS�R.ATNE OFFSCES � <br /> =�7E'pRMATION DISCLOSIIRE RE4�ST <br /> � MSNNESOTA Ga DATA PR�CTICES ACT <br /> • ggQUES2'ER NOTE: . - <br /> g, gecruest Frequenc� - Private D a infor�ed� ofaitssmeaning, the <br /> have been supplied the aata an ou for six mon�chs thereafter <br /> data ueed not be disclosed to y <br /> .unless a dispute or action is pendina or additional data -on <br /> yvu .has been col.Iected. <br /> g. you may be reauired to pay �actual cos�s in making� <br /> certifying and/or com�iling the co�ies o= in=ormation <br /> requested. • <br /> Date of Request: <br /> �';� �?L' ��'� <br /> � �`q�' �C-�' S. .SG�v%�i <br /> ester Names <br /> Req'a . �' <br /> _� �� 7� S j,F'C ��� City: ���� <br /> p�ddress: � � <br /> Zip: Ss j Z % /, ��/�- <br /> ��. L�S� . L�`Q �C` Business: G�� '�r <br /> gome Phone: <br /> Description of Information Kea_uested: <br /> �'%���' /����� C' <br /> Recruester`. s Signature: <br /> ,,;;����-�:�l '�----�' <br /> BgyOW �7gORMATION Tb��E FII+LED IN BY DEPARTMSNT ONLY <br /> '�_� ; Handled By= �. <br /> D ep ar�ent: _--� ; <br /> Mail. Phone <br /> gequest Type2 _�.In pe=san . — — <br /> gequested By= — <br /> Subjec� of Data Not Sui�ject oi Data <br /> Tnformation R�qu <br /> ested is Classi.fied: ?ublic _Private <br /> Nan-?ublic -rotected Non-Public <br /> Conf idential -- <br /> Approved Denied A�proved in_Par'� <br /> gequest is: _ -- <br /> Remarks/Co�ents: <br /> Anthori.zed Signature: <br /> = S <br /> Fees:• X Total Due •- <br /> No. of Pages Rate per Page <br /> �� . � � �� ����'Z�_ <br /> �. a-��-��� - <br />