HomeMy WebLinkAboutRe: data request-1998 ORONO ADMINISTRATNE �FFICES
INFORMATION DISCI�OSIIRE REQIIEST
MINNESOTA Ga DATA PR�CTICES ACT
' gEQIIESTER NOTE: . . . . �
p,, 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 thereafter
unless a dispute or action is pending or additional data �on
you has been collectefi.
g. You may be required to pay actual costs in making,
certifying and/or comailing the copies oi inf ormation
requested. �
Date of Request: � �� �� "
� � �a,h-���:� � ��%�`-
Requester Name: ^ Cz�
Address:
�,� � �, �,�+'". city: �• C�O
Zip: �� �
Home Phone: J`t`!"� (��� Business:
Description of Informatioa Re�quested:
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O r����
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Requester: s Signature:
HELOW INFOFtMATION TO BE FII�LED IN BY DEPARTMSNT ONLY
�j �2 Ha.n.dled By:
Department: -
In erson Mail Phone
�tequest Type: �_ P —
ested B Subjec� of Data _�_Not Subject of Data
Ftequ Y=
Inf ormation Requ
ested is Classified: �_��Ii� private
Confidential Non-�ublic =rotected Non-Public
Re�quest is: �Approved Denied Approved in_Part
Remarks/Camme�ts:
Authorized Signature:
= S
Fees:• X Total Due
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