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Home My WebLink AboutRe: data request ORONO ADMIN=STR�TIVE 0�=�S • 2NF'ORMATION DISCLOSURE RESZ�ST . • - 1�1SI�T�TESOTA GO DATA PR�CTICES gCT , • ggQL7ESTF�t NOTE= • " Af ter you A, gequest Frequenc� - Private� Data on individuals. th� hzc•e been supplied the data and uf faresixf aontnsehreafter • data ne�d not be disclosed t� yeadinc or additional data -on . • . .unless :a dispute or ac�ion is •p . � . • � you .has� beea. collected. . � you may be reauired to pay��zctual cos�s in makina; B- the copies or inioraatior_ certifying and/ar co�piling =equested. `�� O ' Date of Reqaest: _ r . • � gequester Name= �j� , City: ��/?� p�d,dress: v Z3.D' • $��@SS: H�e Phone: Descr -an f o , atioa R _ este3:. J . � Recrues�er`.s Signature: Bg,LOW INFORMATION TO BE FII�I,ED IN BY DEPAR�'T ONZ'Y Handled sy: D ep ar`'�ent: Mail. �hone geqnest TyPe= In person . — -- Not Subjec� of Data geques�ed Ey- Subjec:. of Data __ . ?unlic Private �o�atr.on Requested is Classified: =rotected Noa-�ubZzC . Confidential Noa-�ublic , ._._. . Denied � Annroved in_Pat gecuest is: Aporoved — ---- • Re�arks/C��ts: � j� K_. ,..r.�•�'K- °� 'zed SigIIature: G�' ,-`,;,'` ' Antb.on «�,• ;, = S X Total Due Pees:• NQ. a f ��geS Rate per Page f �� ,��-� � .� �� %a �� _ � .��-` / �; , �=-�� . ��r� s �� l� 5�" , � � � � 3� � a� � . � , � 3 0 3� ��-� _ � �� l � � � �� '��° � � �� _ �� 1 � 7� � �� 1 �-�- �� so -�� — � � � � Il �s � � �� S� � � O � � � 1 t � � �-� �- � ^ ✓ � � �' � � � �� 2. �/ � � _ � �� . � � ` �. _ � � . �� S �� ✓ � , �s �U _ �� ' ,�o � � � � ��