HomeMy WebLinkAboutrequest for information ORONO ADMSNISTRATSV� OFFI�S
=NFORM�ITION DISCI�OSIIRE R�4�ST
MSNNESOTA C� DAT� PR.ACTICES ACT
�Q�S�gR NOTE: ' �- on individua�s. AitAr y°u
A, Request Frecuency - Private Da�.a
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have be�n suppl.ied the data ana uf fQ e`31X=�on�sethereafter
data need not be disclosed to y
ute or action is pending or additional data -on
unless a disp .
you has been coZlected. zCtual costs in making,
vou Inay be reau'-red to p�Y �^ o= inrormation
B. certifying and/or compiling �.l.e copies
requested.
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Date of Re�eSt: � � / , ..
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Req�ester N�e= ` � /
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Description of Znformation Reuueste�:
Re�uester' s Signature=
BELOW INFORMATION TO BE F�� I� BY DEPARTI�NT ONLY
Handle�d BY=
Depart��t=
Mai� �hone
Request Type- —In persan —
Not Su.i�jec� of Data
Subjec� or" Data —
Requested By= ,
��Zyc pTyvate
Tnfo�ation Requested is Classifie�:
�ub1;c =r°teC+�d Nan-Public
Consicential Nor�--
g�quest is: Approved
Denied Approved in Part
Re�r3�cs/Ca�me.nts:
Aut�iorize� Signatnre:
_ $
X Total Due
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