HomeMy WebLinkAboutrequest for info ORONO ADMINISTRATIVE OFFS0-°S
INFORMATION DISCLOSU-:LE P-EQUEST
HrNNESOTA G40VEPIUCENT DATA PRACTICES ACT '
R QUESTER NOTE:
' Pester you
A. Bequest Frequency - Private Data on individuals. aningr the
have been supplied the data and ouf f resixf monthsethereafter
data need not be disclosed to y
. .unless
a dispute or action is -pending or additional data -o^-
you .has been collected.
you may be required to pay actual costs in making;
B. - • and/or compiling the copies or inforaation
ger cif Ying
requested.
Date of Request: Co -�
Regaester 'Sa=e:
�z11 City:
Address:
Business:
Home Phone:
Ct
Description of Information Requested:
of
ature:
Recruestes'. s Sign -�
BELOW INFORMATION TO BE FILL]ED IN BY DEPARZ'I�=NT O '�'
Depar�•=ent: G G�lrw,
Handled By:
Bequest Type= —In person .
Mzi; Phone
Requested By: —
Subject-- of Data Not Subject of Data
Tnformat- Requested is Classified:
Publi c _Private
protected Non-Public
Non-public
_Confidential in Part
u
Reqest is: Approved
Denied Approved
Rem. Tks/Conv=ents:
Authorized SignatBre:
Fees:- x Rate per Page Total Due ,.
arm _ of Pages .