HomeMy WebLinkAboutRe: request for info ORONO ADMINISTRATIVE OFFICES
INFORMATION DISCLOSURE
DATA PRACTICES ACT
MINNESOTA GO
• REQUESTER NOTE:
' After you
A.
Rea_uest Frequency - Private' Data on individuals. the
have been supplied the data and onf fa esixfmcnthsethe meaning,
data need not be disclosed to y
.unless :'a dispute or action is pending or additional data -on
you .has~been• collected. a actual costs in making:
B. You may be required to pay
certifying and/or compiling the copies of information
requested.
Date of Requ
est: A- 2r �
Requester Name:
Address: 91? /1 A --
S city: _4.1"___I___
Zip: . i/j _ "- l?fin _
Business:
Home Phone:
Description of Information R
equested:. „L air�i ”
/ o / . .
5sr .G/G f o- o few...e w-.riD.+!! '
a �� ,
' RegIIester'. s Signature:: EPART�T ONLY
BELOW INFORMATION TO BE FILLED IN BY D
Department: HandlDepartment: phone
In person Mail Rest Type: —
Subject of Data
Not Subject of Data
Requested By: �_ Public ac Private
Information Requested is Classified: Pub -Public
Non-Public Protected Non
Confidential -- � _p, Part.
Denied • Approved
Request is: Approved Den
---
Remarks/Comments:
Authorized Signature: '
x
No. of Pager Page Total Due
Fees:* •, es Rate p
•