Laserfiche WebLink
TE,NNIESSEN WARNING <br />F-J':J014 WINI'd a] tdM] <br />In connection with your application for appointment to a board or commission the City has asked <br />that you provide it with information about yourself which is classified as either plimle or confidential <br />by the Minnesota Government Data practices Act (MS 13.0�4). Accordingly, the City is required to <br />inform you of the following: <br />1. Residential address, telephone number, and email address are private. Once appointed to a <br />public body, the data becomes pul')lic. <br />2. The private or confidential information requested includes the following- additional contact <br />injbrmation on the supplemental applicationpmi4ded in orderlbr staff to reackyou. <br />3. The purpose and intended use of the information requested ls:j r City Cozindl and; iqffntiew and <br />process our application. We willalso needthe i#browalion you are appointed in order or ulo e o&iin <br />Y fi 'yo p ?f r <br />_yomr role as a board wenyber1comivissioner. <br />4. You are not required to supply the requested information. <br />5. The known consequences of refusing to supply the requested information is.- delay in nozy)jriig_you <br />and sen&ng information to you that is hvipoilant to perlbim.your duties as a board weyvberl co.9imissioner. <br />6. The following persons and entities are authorized by law to receive the information if provided: <br />City Council and siqff'wbosexor.assignments require acaus. <br />The undersigned, by signing this notice, acknowledges, that he/she has read and <br />understands the contents of this notice. <br />I - I -L. ,-I I <br />Date <br />Signature of Appli 'ant <br />print Name <br />