HomeMy WebLinkAboutRe: request for info ORONO ADMINISTRATIVE OFFICES
INFORMATION DISCLOSURE REQUEST
MINNESOTA GOVERNMENT DATA PRACTICES ACT
REQUESTER NOTE:
A. Request Frequency - Private Data on individuals: After you
have been supplied the data and informed of its meaning, the
data needanot be orsclosed to you for acti n is pending or amonths
d ti nal thereafter
-on
unless a dispute
you has been collected.
B. You may be required to pay actual costs in making,
certifying and/or compiling the copies of information
requested.
Date of Request:
Requester Name: L/� Jo/4/s 0 i
/ c....774-c....774- City: .5-7.e,.5-7.e, 4 L ice,A)),1,
Address: `J����
zip: s� /-,
Home Phone: 9a� - �o�` Business:
Description of Information Requested:
Requesters Signature: 4IP wee
„6.1.1wr
BELOW INFORMATION T! BE 'ILL:5'. IN BY DEPARTMENT ONLY
Department: Handled By:
Request Type: In person Mail Phone.
Requested By: Subject of Data Not Subject of Data
�
Information Requested is Classified: Public Private
Confidential Non-Public Protected Non-Public
PP
Request is:
Approved Denied Approved in Part
Remarks/Comments:
Authorized Signature: hihirli ,
, = $
Fees: x 1Total Due
No. of Pages Rate per Page .. `
1