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Page 14 of 22 <br /> <br /> <br /> <br /> <br />City of Lake Elmo Data Practices Policy 01/03/2024 <br />information we will not be able to begin processing your request until you contact us. <br />City of Lake Elmo Data Request Form – Data Subjects Date of request: _____________ To request data as a data subject, you must show a valid state ID, such as a driver’s license, military ID, or passport as proof of identity. <br />I am requesting access to data in the following way: <br />⎕ Inspection ⎕Copies ⎕ Inspection and copies <br />Note: inspection is free, for copies we charge $0.25 per page for up to 100 pages ($0.50 two sided up to 50 pages) or employee time, the cost of the materials onto which we are copying the data (paper, CD, DVD, etc.), and mailing costs (if any). If your request is for copies of data that we cannot reproduce ourselves, such as photographs, we will charge you the actual cost we must pay an outside vendor for the copies. The cost of employee time to make copies is calculated at the actual hourly rate of the employee. <br />Description of data requested: <br />Note: Describe the data you are requesting as specifically as possible. If you need more space, please use the back <br />of this form. Contact Information Data subject name______________________________________________________________ Parent/Guardian name (if applicable) _______________________________________________ Address______________________________________________________________________ Phone number_____________________ Email address________________________________ Signature of Data Subject or Parent/Guardian_________________________________________ <br />Staff Verification