HomeMy WebLinkAbout09-08-1998 - Info Discl. reque. ORONO ADMINISTRATIVE OFFICES
INFORMATION DISCLOSURE REQUEST
MINNESOTA GOVERNMENT DATA PRACTICES ACT
REQUESTER NOTE:
A. Request Frequency - Private Data on individuals. After you
have been supplied the data and informed of its meaning, the
data need not be disclosed to you for six months ending or add tionaledatat-on
er
unless a dispute or action is p
you has been collected.
B. You may be required to pay actual costs in making,
certifying and/or compiling the copies of information
requested. q c
Date of Request: l o
Requester Name: � ,
Address: 0.-09
E,..+C.8-\ C cr2 2.tL �C - City: (,3 C
Zip: s(3 �t1
Home Phone: 413 --? 170 Business:
Description of Information Requested: S L
i
Requester' s Signature: ,:r----7.--7-.) i 4.101C
BELOW INFORMATI TO BE FILLED IN BY DEPARTMENT ONLY
�c. Handled By:
Department:
_Z1L_______
Request Type:
01-In person Mail Phone
Requested By: Subjectof Data DC, Not Subject of Data
Information Requested is Classified:
04- Public Private
Confidential Non-Public Protected Non-Public
Request is: p .. Approved _Denied Approved in Part
Remarks/Comments:
/ (cLicy..em.s..
ed Signature:
Au-thora.zA ',
Fees: xTotal Due
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