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PUBLIC DATA REQUEST FORM

Pubic Data Request Form

You are not required to provide contact information; however, failure to complete the form could delay in the processing of your request, as we may need to contact you for further information or clarification.
Requestor
MM slash DD slash YYYY
Street Address

Description of Data Requested

Pursuant to the Minnesota Data Practices Act, Statute Chapter 13, I hereby request the following information. Please provide as much information as possible. Indicate the format desired for the information you are requesting.

In making this request, I understand that:

• LOWSO is under no obligation to create a document that does not already exist, or to comply with a stand request for information.

• Items expressly confidential under law will NOT be disclosed per Minnesota Statute Chapter 13.

• LOWSO will provide the requested information as expediently as possible. Depending on the type of information requested, it may take up to ten (10) business days. If the requested information is time sensitive, please indicated above and the Records Division will make every effort to comply.
Clear Signature