HomeMy WebLinkAboutrequest for info ORONO A.DMINISZ'RATIVE OFFICES
INFORMATION DISCLOSD�ZE KE4IIEST
MINNESOTA GO DATA PRACTICES ACT
REQIIESTER NOTE:
pl, Request Frequency - Private Data on individuals. After you
have been supplied the data and informed of its meaning, the
data need notube o�sac°Son is pEnding or add tional edatat-on
unless a disp ,
you has been col.Iected.
g , you may be required to pay actual costs in making,
certifying and/or compiling the copies oz information
requested.
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Date of Request: -- - ;;
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Requester Names
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Zip: �� '�� � —
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Description of Information Re�quested: i��'l��>���''�'rl��'��
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Requester'. s Signature: / ' �' �� " -
BELpW INFORMATION TO BE FI7,ZED IN BY DEPARTI�:NT ONLY
Handled By:
Department:
In erson Mai1 Phone
Re�quest Type: P
ested B Subject of Data Not Subject of Data
Re�qu Y=
Information Re�qu
ested is Classified: ?ublic Private
Confidential Non-�ublic =rotected Non-Public
gequest is: Approved Denied Approved in Part
RP�narks/Conffients:
Authorized Signature:
_ $
Fees: X Total Due
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