Laserfiche WebLink
ORONO ADMINISTR�TNE OFFICES <br /> INFORM�TION DISCLOSIIRE 12EQIIEST <br /> MSNNESOTA Ga DATA PRACTICES ACT <br /> REQIIESTER NOTE: <br /> A, Request Frequency - Private Data on individuals. After you <br /> have been supplied the data and informed of its meaning, <br /> the <br /> data need not be disclosed to end ng or aaa ti nal edatat�on <br /> unless a dispute or action is p <br /> you has been collected. � <br /> g, You may be required to pay actual costs in making, <br /> certif ying and/or compiling the copies oi inf ormation <br /> requested. � <br /> - Date of Request: ����� <br /> Requester Name: ���A �A � <br /> �aaress: <br /> a��g �zty: L�U ��L <br /> Zip- <br /> Home Phone: " 1� � � �B ° `� Busine s s: <br /> • Description of Information Requested: <br /> . <br /> , <br /> Requester: s Signature: <br /> BELOW INFORMATION E FI7�LED IN BY DEPARTMLNT ONLY <br /> Depart�ent s <br /> Ha.adled By s <br /> Request Type: <br /> In person Mai1 Phone <br /> ested B Subject of Data Not Subject of Data <br /> Requ Y= <br /> Inf ormation Requ <br /> ested is Classified: �ublic Private <br /> Confidential _Non-�ublic _rotected Non-Public <br /> Denied Approved in Part <br /> gequest is: Approved ,_._ <br /> Remarks/Com�ments: <br /> Authorized Signature: <br /> _ $ <br /> Fees:� X Total Due <br /> No. of Pages Rate per Page .. <br />