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EXHIBIT 4 <br />-AF,QEN_ HILLS <br />,111wKe]ff_10Q40INII*.*I <br />REQUEST FOR INFORMATION <br />Minnesota Government Data Practices Act <br />A. Completed by Requestor <br />REQUESTOR NAME (Last, First, M.): <br />DATE OF REQUEST: <br />STREET ADDRESS: <br />PHONE NUMBER: <br />CITY, STATE. ZIP CODE: <br />EMAIL ADDRESS: <br />SIGNATURE: <br />DESCRIPTION OF THE INFORMATION REQUESTED: <br />The City makes every effort to respond to data requests in a reasonable amount of time (generally within five (5) to seven (7) <br />working days). Please note that larger data requests typically require additional time. We appreciate your patience. <br />B. Completed by Department <br />DEPARTMENT NAME: <br />HANDLED BY: <br />INFORMATION CLASSIFIED AS: <br />ACTION: <br />❑ PUBLIC ❑ NON-PUBLIC <br />❑ APPROVED <br />❑ PRIVATE ❑ PROTECTED NON-PUBLIC <br />❑ APPROVED IN PART (explain below) <br />❑ CONFIDENTIAL <br />❑ DENIED (explain below) <br />REMARKS OR BASIS FOR DENIAL INCLUDING STATUTE SECTION: <br />PHOTOCOPYING CHARGES: <br />IDENTITY VERIFIED FOR PRIVATE INFORMATION: <br />❑ NONE <br />❑ IDENTIFICATION: DRIVER'S LICENSE, STATE I.D., etc. <br />❑ Pages x = <br />❑ COMPARISON WITH SIGNATURE ON FILE <br />❑ Special Rate: (attach explanation) <br />❑ PERSONAL KNOWLEDGE <br />❑ OTHER: <br />AUTHORIZED SIGNATURE: DATE: <br />190435vl <br />19 <br />