HomeMy WebLinkAbout1998 - Info Disclosure request ORONO ADMINISTR.ATIVE OFFI�S
INFORMATION DISCLOSIIRE REQIIEST
�+iINNESOTA GO DATA PRACTICES ACT
REQIIESTER NOTE: .
A, Request Frequency - Private Data on individua?s. After you
have been supplied the data anci informed of its meaning,
the
data need not be disclosed to you for six months thereafter
unless a dispute or action is pending or additional data -on
you has been collectec.
B, You may be required to pay actual costs in making,
certifying and/or compiling the copies oi information
requested.
Date of Request: /�
Requester Names
V� � � �
� /" �_ City:
Address: /
Zip: ��1�/ %
(� 7 L Business: � �C �
gome Phone z ( ` � /
Description of Information Re�uested:
Requester' s Signature: �
BEI�OW INFORMATION TO BE FII,LED IN BY DEPARTM�?NT ONLY
Handled By:
Department:
Request Typ
e: In person Mai1 Phone
Ft ested B Sub j ec�- of Data Not Sub j ect of Data
e� y' ..
Inf ormation Requ
ested is Classified: ?ublic Private
Confidential
Nan-Public -rotected Non-Public
gequest is: Aoproved Denied Approved :in Part
Remarks/Co�ents:
Authorized Signature:
_ $
Fees: X Total Due
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