HomeMy WebLinkAboutRe: request for info ORONO ADMINIS�RATSYE ��=�S �
INFORMATION DISCLOnS��P��I�S gCT
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• gEQUES�ER NOTE= '� ' ?ndividuals. After you
A, gecruest Frequency - Private Data o�
the
have been supplied the data and oufQQ es�xf�on�:nse hereafter �
data ne�d nvt be disclosed to y
.unless .�a dispute or ac�ion is �pending or additional data -on
you .has been collected. _
You may be reauirec to pay��actual �cos�s in �akinq,
S. zhe copies o� in=oraztiOP
ce=tifying and%or �o�Piling
requested. •
est: - ZZ -- O/
Date af Requ ,
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Name= '
Req�ester , � . , 2 �>�� /
�I � City:
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Descript-ion of =�O�a��n R�ested_,
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Reaues..er'. s Sign
BFyOW 127gORMATION TO BE FII�LE� I� BY DEPART2�+'--''NT O�TI'Y
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D ep art�-aent= ��"�
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ge�uest Type= � In Pe=san . — —
R�eSLe� By= _Subjec� oi Data
�_Not Sunject or Data
��u:nlic Private
=�o�mation R�q�ested is Classified= —
=rotected Non-Public
Na�-?ublic .
Considential — . � �n Par�
Denied � Annroved
geuuest is: �,APoroved — --'—
Re�sarks�Ca�.ests:
Anthon-zed Sign.at�re: �
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Fees:• X Tota1 Due ,_
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