HomeMy WebLinkAbout2000 info disclosure request ORONO ADMINISTRATIVE OFFICES
INFORMATION DISCLOSURE
PREQUEST
C PRACTICES ACT
MINNESOTA GOVERNMENT
•
REQUESTER NOTE: •
A. Request Frequency - Private Data on individuals. •
After ou
have been supplied the data and informed
ofx laitshsmeaning,
thereaft the
data need not be disclosed to you
r
unless a dispute or action is pending or additional data -on
ou has been collected.
B. You may be required to pay actual costs in making,
certifying and/or compiling the copies of information
requested.
.
Date of Request: ,1z - GG�j
Requester Name: v ' hi '2 '
Cit 4LL s . l n z, _
Address: 3� . � �irrp "`
zip: 5 LLE_
awe Phone:
/' ll.'., G f Business: _f_25_::12:12_1___
Description of Information Requested:
llir
Requester'. s Signature: A��,�
�
. IN BY DEPARTMENT O •Y_,_
BELOW INFORMATION TO :E FILL'
Handled By:
Department:
Request Type: _In person .
Mail Phone
Requested By:
Subject. of Data Not Subject of Data
Information Requested is Classified: Public Private
Confidential
Non-Public _ protected Non-Public
Approved Denied Approved in_Part
Request is:
Rema rks/Comments:
Authorized Signature:
Fees:- x Total Due
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