HomeMy WebLinkAboutData request ORONO ADMINISTRATIVE OFFS�S
I3�FORMATION DISCLOSIIRE R�Q�ST
MINNESOTA Ga DAT� P��ICES ACT
ggQUESTER NOTy� on individua?s. After you
A, Request FrequencY - Przvate Data
the
have been supplied the data and uf=or esix montnsethereafter
data need not be disclosed to y
un1ess a dispute or action is pending or additional aata -on
you has been coZlected. zcttzal costs in making.
B , you may be reauired to paY
certif ying ar_d%or compi ling
�re copies oi in=ormat�on
requested. �
Date of RequeSt= l� 3`�S�
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Requester Name: i,,A-��,
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Description of Inf ormat�on R�ueste�:
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Rec3uester' s Sign
ature: Gf.`t
BgyaW TNgOgMATION TO BE FII,.LE�
, B DEPARTMSNT ONZY
gandlet3 BY=
Departme.nt=
Reqc�est Type: _In perscn
Mai� Phone
Not Subjec� of Data.
gequeste� By= —
Subje�� o= Data —
Infotmation Requested is Classified:
�ublic —PrzVa`e
Nor.-�ubZ=� =rotected Non-PuDlic
Conridential __
Rer�uest is: ApDroved
Denie� Approved in Part
Re�ar3�cs/Ca��ts=
Aut�iorize� Signature:
_ $
X Total Due
Fe�s: g Rate per Fage "
No. of Pa es