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Home My WebLink Aboutdata request ORONO ADMSN=S�RAT=VE �F�=�S • 1�`TFORMAT=ON DISCLOSIIRE RESZ�ST . • • �S�NESaTA Gp DATA PR�CTICES ACT . • ggQUESTSK NO�E: • � • • Af ter you A, geauest Ereque�cy - Private� Data on individuals. the hati-e been supplied the data and uf fa�Si°f mantnse herea�ter � data ae�d aot be discl.osed t� yendinc or additional data -on . � . .unless :a di5pute or ac�ion is -p . .. . . . � � you .has� been collectec. . ' � you may be reauired to 'pay"a�tual cos�s in �aking; B' and/or compiling the copies o� in=orrsatio� certif ying requested. �//�� D • � � , Date cf Request- , . , Req�ester Name s �� . �,� , City: Address: v ` � Zip= � H�e Phane s Busiaess: Descr 'oa f o , atiaa R _ ested:. ' Reqaes�er'. s Si.,gnature: BgyOW �7'pORMATION TO BE FII.LID IN BY DEPARTI�HT ONZ'Y Handled By: Depart��t= Mail. Phone gequest Type= In person _ — geques�ed By= Subjec� of Data Nat Sub�ect of Data ?ui�lic Private 7nfarmat.�.on Reqaested is Classified= — No�-?ublic __=rotected Noa-Public Conf idential . • Denied � Anproved in_Pat gecaest is: ,_ Aoproved — --- ' . � Rem.arks/Caamtents- . . � G,/ JC ...� � � ,r....v. Anthorize3 Signature: ��;�rr - $ � Pees:- x Tctal Due „ No. af Pages Rat= per Page . - ; �� ! � � a ��'�- _ . ��-. � � � . �� s �� =-,�� l� _5� . � � � � � � 3� _ � a� . , � �3 0 �� a�-� _ � �� l � � � �c� "-�° , � e � ��' �� 11 � �� ✓ � �� s� — � � � r I � 8�s ��c�� = �� S` �' � � � O � � � 1 �, � �-�-� � � ^ ;/ � �Z c�l�c � � � a � ,� ��. �/ � � � �� - � c �. - � � �� S �� r �� - ✓ � �� s _ �� ' �/° � �f f � ��-�