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<br />. . <br /> <br />(i. <br /> <br />CITY OF CENTERVILLE <br /> <br />GENJ:RALAUTBORlZA110N AND RU61l.6Sl'- <br /> <br />......... tit I'R-.esofa ..... 8......10.05. Suhd. 4 <br />.....---Data Pnldeu Act <br /> <br />TOt 'City ofClater9il1e <br /> <br />r. ~ ~ - heriby .1,6.0-1..... _JqylnfbtdW CODSIIIIto <br />pemi.tyou. DCA. FBI. NCIC. ~~ ofMcdDrVe1do1-..1be City ofCeldmill. <br />to .... to . IIIIIko aYIIiIab1e to 1he Citr of CeaIer9iIIeIC-.........., Labs Pall. <br />J)epaameDi or1helr...... as ~ data ,,",-"IIsd . priYaae wbfch CplMINI _ aad <br />which., he ill YOUI' posI-~ 1he data wbich I MIIINwi_ to be relll114 ~...... of <br />pdvIde ...... . dtJt~ .., Ui.ll.Iwofa .. S1BIaI8 113.02, S1Ibd. 12. ad lias .... <br />con... by you . a rB1It of my C-~.I... aJor ~1tf0Jl8 with Y01l aJor YOII' <br />8J8Id8 IIIld ..... .J~~i.. 1he i..&. ....... for wIaich __ is atJtorI'ed'iDcluda aD <br />daIa which bas heeD aoDectecJ.. ..... 1-vi.veI. M:...,a or.. .d..at" ill ..... <br />fomt. which iD 8IlJ ..., mlates to ,., ~ with you or your 1pIlCf. I ..... <br />dud; 1be IWJOW of J- ...;If'.~ 1he City of CeatemIIeICeo.C......1e1 Labs Police <br />DepaIllleD1 or ... 8pDfB to have access to this ;.d\.IMIlI~ is to dAh..1\.1... ,., <br />p1iftcati~ for a city Iicease <br /> <br />This .,A...i~ s1udl be valid for a period of ODe (1),... but 1&6.. 1be dabt to, at <br />lIlY 1ime prlor to dud; exphWcm. cancel t1m wriUIBl-4J.~ :,JdJOD by proyidD:ta wIitteD <br />IlCI1ice to die City of ~ Labs Police DIpadmeat or their.... as <br />_..... of1bat filet. <br /> <br /> <br />~ <br /> <br />\, ~,., <br />Date <br /> <br />---10\\0 .~\~ '~ <br />.FaIl ~ Pd1dId: first MicIdIe LI8I <br /> <br />':lif" <br />Date of <br /> <br />(Attach Copy ofDri\'er's License) <br /> <br />~/ <br />