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Exhibit 5 <br />CONSENT TO RELEASE PRIVATE DATA <br />I, ,authorize the City of Ramsey to release the following private. <br />data about me: <br />to the following person or people: <br />The person or people receiving the private data may use it only for the following purpose or purposes: <br />This authorization is dated anal expires on <br />'The expiration cannot exceed one year from the date of the authorization, except in the case of authorizations given <br />in connection with applications for life insurance or non-cancelable or guaranteed renewable health insurance and <br />identified as such, two years after the date of the policy. <br />I agree to give up and waive all claims that I might have against the City, its agents, and employees <br />for releasing data pursuant to this request. <br />Signature <br />IDENTITY VERIFIED BY: <br />^ Witness: X <br />^ Identification: Driver's License, State ID, Passport, Other: <br />^ Comparison with signature on file <br />^ Other: <br />Responsible Authority/Designee: <br />24 <br />