Laserfiche WebLink
City of <br /> Pc not <br /> Lakes._= _ <br /> DATA RELEASE FORM <br /> In accordance with the Minnesota Government Data Practices Act,the City of Pequot <br /> Lakes is required to receive your consent before releasing any information about you that <br /> is classified as private data. Private data is information that is not available to the public. <br /> If appointed to an Advisory Commission or elected as a City Official,I authorize the <br /> City of Pequot Lakes to disclose the following information.You must choose at least <br /> one phone number or e-mail address to be made public. <br /> ❑ Board and Commission <br /> ❑ Name /414,1-4- <br /> 0 <br /> %❑ Home Telephone Number _ <br /> <br /> <br /> <br /> pi Cell Phone Number 02/P.' F.26 - 9029/ <br /> O Other <br /> Signatures � : Date: ,fes /5 <br /> This release will be in effect as long as you serve on the Board,Commission, <br /> Council,or Task Force and can be changed upon your request at any time. <br /> SMdministralion\City Clerk\Boards and CommissioreVApplication Process and FonasWonns\Application Form for Boards and Commissions.doc <br /> Page 5 <br />