HomeMy WebLinkAboutrequest for info ORONO ADMINISTRATIVE OFFICES .
INE'Og�S�1TION DSSCLOSIIRE R�4�ST
MINNESOTA Ga DATA PRACTICES ACT
REQIIESTER NOTE:
A. Request Frequency - Private Data on individual.s. After the
have been suppl.ied the d etda �o a oufforesixfmontnsethereafter
data need not be disclos yending or additional data -on
unless a dispute or actioa is p
you has been collected. a �,ctual costs in making,
B, you �ay be required to P ytre copies o= information
certif ying and/or compiling
requested. �
Date of Request: \� \
, , .
Requester Namez (�
City: ���
p,ddsess:
Zip:
Business s � R
H�e Phone: ���__���C�� �,..e. \1
Descrip'�-on of Informat�oa g�uested:
�" ' � l�.ti � ��-�
Reqaester` s Signat�re:
BgyaW IZ�7gOgMATION TO BE FII� IN BY DEPARTI�:NT O�'Y
Handled BY=
Department:
Mai? _Phone.
gequest TYPe:
In person —
gequested By: Subjec� o= Data
Not Subject of Data
��, Zi� _Private
Tnfoffiation Reqneste3 is Classified=
Noa-Public =rotected Non-Public
Conf idential —
Denied Approved in Par�
Re�ueSt 1S� Aporoved --i -
Remar3ts/Camments:
Authorized Signat�e:
_ $
X Total Due
Fe�s:� Rate per Page "
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