Laserfiche WebLink
ORONO ADMINISTRATIVE OFFS�S <br /> INFpRM�TION DISCLOSII� �Q�ST <br /> MSNNESOTA Ga DATA PRACTICES ACT <br /> g�QIIESTER N0� - Private Da�a on individuals. After you . <br /> A, Reques� Frequency <br /> t e <br /> have been supplied the data and uf foresix montnsethereafter <br /> data need not be disclosed to y <br /> unless a dispu�e or action is pending or additional data -on <br /> you has been coZlected. <br /> v actual costs in making� <br /> g , you may be required to pz . <br /> certiryin5 ar.d/or corapiling <br /> t'r.e copies oz in�or���'-on <br /> requested. � <br /> � <br /> -�� ; =-, <br /> Date of Rec�est: � '� �` <br /> : � � � � �' <br /> �� � ) 1_ ,,_ �. ,�:_� �� <br /> Requester Name: � � ���� -��l <;-- <br /> � , � � F f�� �-ty' � <br /> pyddress: % % - <br /> Zip. - � � � `' �_ ' ��, r�`�_� <br /> � `' � 1 �,;';, ; Busines s= <br /> H�e Phone- _ ,,� . <br /> Description of Znfor�at�.on R�Iested: <br /> Re�ester` s Sign�t�e: <br /> BEI,OW =NgORMATION TO BE FII.L� IN BY DEPAR�NT ON�Y <br /> Handled BY= <br /> Departsue.nt: <br /> Mai? Phone <br /> Request Type= —In Pe'-"son — <br /> Sup�ec� or Data <br /> Not Subject of Data <br /> gequested BY= — <br /> Tnformation Requested is Classifie�d: <br /> =ublic _Private <br /> Non-?ublic =rotected Non-Pu�lic <br /> Conf iCe�tial — <br /> Deniea Anproved in Part <br /> gequest is: Approved — <br /> Remaz'3�s/Camments: <br /> Authorize� Signature: <br /> _ $ <br /> X Total Due <br /> Fees: No. of Pages Rate per Page .. <br />