STATE OF WISCONSIN
Town of ________
________ County
TO: ________ [Record subject]
A request for access to the following record of the Town of ________, ________ County, Wisconsin, has been granted by the Town: [specifically describe record here].
You are the subject of the requested record.
The requested record is subject to the provisions of
s. 19.356, Wis. stats., as the record is [choose Option A, B, or C, as applicable]
(Option A) a record containing information relating to an employee that is created or kept by the Town and that is the result of an investigation into a disciplinary matter involving the employee or possible employment-related violation by the employee of a statute, ordinance, rule, regulation, or policy of the employee's employer.
(Option B) a record obtained by the Town through a subpoena or search warrant.
(Option C) a record prepared by an employer other than the Town that contains information relating to an employee of that employer, unless the employee authorizes the Town to provide access to that information.
Under
s. 19.356, Wis. stats., all of the following conditions apply to the grant of access to the requested record:
1. Within 5 days after receipt of this notice, you may provide written notification to the Town of your intent to seek a court order restraining the Town from providing access to the requested record.
2. Within 10 days after receipt of this notice, you may commence an action seeking a court order to restrain the Town from providing access to the requested record. If you commence such an action, the record requester may intervene in the action as a matter of right.
3. The Town will not provide access to the requested record to the record requester within 12 days of sending this notice. In addition, if you commence an action as described in paragraph 2, the Town will not provide access to the requested record during the pendency of the action. If you appeal or petition for review of the decision of the court or the time for appeal or petition for review of a decision adverse to the record subject has not expired, the Town will not provide access to the requested record until whichever of the following occurs first:
a. Any appeal is decided.
b. The period for appealing or petitioning for review expires.
c. A petition for review is denied.
d. The Town receives written notice from you that an appeal or petition for review will not be filed.
Dated this ______ day of ________, 20__.
[Signature of town clerk (or other record custodian)]
Note:
Section 19.356 (2) (a), Wis. stats., provides that the Town shall “within 3 days after making the decision to permit access, serve written notice of that decision on any record subject to whom the record pertains, either by certified mail or by personally serving the notice on the record subject.”
