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3.4. & 3.5. SR 06-30-1997-'ity of iver MEMORANDUM Item~.6. & 3.5.** TO: FROM: DATE: SUBJECT: Mayor & City Council Lori Johnson, Asst. City Administrator/ Finance Director June 30, 1997 Adoption of Data Practices Act and Resolution Appointing Responsible Authority As you are aware, staff has been in the process of updating the City's Data Practices policy. Peter Beck recommended that the City work with Corrine Thomson, an attorney with Kennedy and Graven, because of her expertise in the data privacy law. This project is now complete with the exception of a resolution which needs to be approved by the Council. Attached is a copy of the City of Elk River Guidelines and Procedures for the Minnesota Government Data Practices Act. Both department heads and staff have had training sessions with Ms. Thomson regarding the law and the City's policy. This document is a helpful guide in determining what information may be released and what may not. Additionally, the law requires that the City appoint by name, not position, a Responsible Authority. The Responsible Authority is the person charged with administering the requirements for collection, storage, use and dissemination of data on individuals. The attached resolution appoints Pat Klaers as the Responsible Authority. Action Requested The Council is asked to approve the attached resolution appointing Pat Klaers as the Responsible Authority for the data practices act and to approve the newly drafted City of Elk River Guidelines and Procedures for the act. 13065 Orono Parkway · P.O. Box 490 · Elk River, MN 55330 · (612) 441-7420 · Fax: (612) 441-7425 RESOLUTION NO. RESOLUTION APPOINTING RESPONSIBLE AUTHORITY FOR PURPOSES OF THE MINNE- SOTA GOVERNMENT DATA PRACTICES ACT WHEREAS, Minnesota Statutes, section 13.02, subdivision 16, as amended, requires that the City of Elk River appoint one person as the Responsible Authority to administer the requirements for collection, storage, use and dissemination of data on individuals, within the City; and WHEREAS, the City of Elk River shares the concern expressed by the legislature on the responsible use of all City data and wishes to satisfy this concern by appointing an administrative- ly qualified Responsible Authority as required under the statute; and WHEREAS, the duties of Respongible Authority have in the past been performed by the city administrator; and WHEREAS, Patrick Klaers is the city administrator of the City. NOW, THEREFORE, BE IT RESOLVED: 1. The City Council of the City of Elk River appoints Patrick Klaers as Responsible Authority for the purposes of meeting all requirements of the Minnesota Government Data Practices Act, Minnesota Statutes, Chapter 13, as amended, and the rules lawfully promulgated by the Commissioner of Administration at Minnesota Rules, Chapter 1205. 2. Mr. Klaers is authorized to delegate the duties of the Responsible Authority to other City employees as Mr. Klaers, in his discretion, determines to be necessary in order to satisfy the requirements of the Minnesota Government Data Practices Act and at the same time continue to effectively and efficiently provide other City services. 3. This resolution becomes effective immediately upon its passage. Adopted by the Elk River City Council on , 1997. ATTEST: Hank Duitsman, Mayor Sandra Thackeray, City Clerk for the CAH114496 EL185-3 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . > . . . . . . . . . . . . . . . . . . . . . I Section I Collection, Storage and Disposition of Government Data Collecting Government Data ................................. 2 Determining What Information Is '"Necessary" ..................... 3 Retention and Disposition of Government Data ..................... 3 Section 2 Classification of Government Data Public Data on Individuals ................................... 5 Private Data on Individuals .................................. 6 Private Data on Decedents ................................... 7 Confidential Data on Individuals .............. . . ............ 9 Confidential Data on Decedents .............................. 11 SummaryData .......................................... 12 Public Data Not on Individuals ............................... 12 Nonpublic Data Not on Individuals ............................ 13 Protected Nonpublic Data Not on Individuals ..................... 14 Section 3 Temporary Classification Temporary Classification for Data on Individuals .................. 15 Temporary Classification for Data Not on Individuals ............... 16 Determination of the Commissioner of Administration ............... 16 Application for Temporary Classification ........................ 17 Recordkeeping Requirements ................................ 17 Section 4 Rights of Subjects of Data - The Tennessen Warning Tennessen Warning - Rights of Subjects of Data ................... 18 Administering Tennessen Warnings ............................ 20 Preparing Tennessen Warning Forms ........................... 20 Section 5 Informed Consent for the Release of Data Why and When Informed Consent is Needed ..................... 22 Requirements for Informed Consent ........................... 23 Implied Consent ......................................... 24 Section 6 Summary Data Requests for Summary Data ............................... 26 Section 7 Requests for Access and Copies of Government Data Requests for Data - General ................................. 29 Requests for Public Data ................................... 29 Requests for Private Data on Individuals or Nonpublic Data Not on Individuals ............................ ........ 30 CAH50884 GA115-26 Requests for Confidental Data on Individuals or Protected Nonpublic Data Not on Individuals .............................. 33 Data Requests Related to Litigation ............................ 34 Denying Requests for Access Data ............................ 34 Commissioner Opinions .................................... 35 Section 8 Information Disclosure Request Form Information Disclosure Request - General ....................... 36 When Completed ........................................ 36 Guidelines for Use ....................................... 36 Section 9 Fees for Copies of Government Data Fees Not Permitted ............. Permitted Fees ................ Fees May be Waived ........... Data Provided with Charte ........ Collection of Fees ............. Record of Copies .............. .........................38 ......................... 38 ......................... 39 ......................... 39 ......................... 39 ......................... 40 Section 10 Parental Access to Data on Minors Access to Minor Data by Parents, Guardians, or an Individual Acting as a Parent or Guardian In the Absence of a Parent or Guardian ....................................... 41 Notification to Minors ..................................... 41 Section 1.1 Challenging the Accuracy and Completeness of Data Right to Contest . . ....................................... 43 Procedure for Contesting Accuracy or Completeness ......... I ..... 1 43 Section 12 Internal Access and Security Procedures Appointment of the Responsible Authority ....................... 45 Assignment of the Designee ................................. 45 Security Safeguards for Government Data ....................... 45 Section 13 Reporting and Review Requirements Reporting Requirements ................................... 48 Data Practices Annual Report ................................ 48 Data Practices Review Requirements ........................... 50 Section 14 Use of the Social Security Number Federal Law Requirements .................................. 53 State Restrictions ........................................ 53 Directions for Use of Social Security Number .................... 54 Glossary of Terms ................................................. 55 CAH50BB4 GA115-26 lI Exhibit A Your Fights as a Subject of Government Data Exhibit B Application for Temporary Classification, Data on Individuals Exhibit C Application for Temporary Classification, Data Not on Individuals Exhibit D Tennessen Warning Development Worksheet Exhibit E Sample Tennessen Warning Exhibit F Informed Consent Form Exhibit G Information Disclosure Request Forms Exhibit H Costs of Copying Services Provided Exhibit I Copy Cost Calculation Form Exhibit J Resolution Appointing Responsible Authority Exhibit K Data Practices Act Compliance Checklist Exhibit L Responsible Authority and Designees Exhibit M Sample Contractor Agreements Exhibit N Data Practices Annual Report Form Exhibit 0 Forms Analysis Worksheet Exhibit P Sample Non -Disclosure Agreement CA.H50884 GA115-26 CITY OF ELK RIVER GUIDELINES AND PROCEDURES iii11 0=171 MINNESOTA GOVERNMENT DATA PRACTICES ACT The Minnesota Government Data Practices Act (the "Act') regulates all government data created, collected, received, maintained, disseminated or stored by a state agency, political subdivision or statewide system regardless of the data's physical form, storage media or conditions of use. Briefly, the Act describes: (1) what information can be collected, (2) with whom the information may be shared, (3) the classification of specific government data, (4) the duties of city personnel in administering the provisions of the Act, (5) access and procedures for access to the information, (6) procedures whereby information may be classified as not public, (7) civil penalties for violation of the Act, and (8) the charging of fees for copies of records. The basis on which a determination of how government data is handled is the classification system. Government data is either data on individuals or data not on individuals. Data on individuals is classified as either public, private or confidential and data not on individuals is classified as either public, nonpublic or protected nonpublic. Since the Act and these Guidelines and Procedures are definition -dependent, a "Glossary of Terms" is contained in the back. Italicized words and phrases contained herein indicate defined terms. These guidelines and procedures are promulgated with the intention of assisting City personnel in the determination of the classification and handling of government data which is maintained by their departments. This manual is to be used in conjunction with the Minnesota Government Data Practices Act (as amended) and the Rules promulgated by the Commissioner of Administration. CAH50894 GA115-26 IA. Collecting Government Data, I 1. Government data "means all data created, collected, received, maintained, or disseminated by any state agency, political subdivision or statewide system regardless of the data's physical form, storage media or conditions of use." (Minn. Stat. § 13.07(7)) Government data includes all papers, cards, correspondence, discs, maps, memoranda, microfilm, photographs, recordings, reports, tapes, writings, computer medium and other data, information or documentary material. (See Minn. Stat. § 138.17). 2. All public officers and agencies are required to keep all records necessary to a full and accurate knowledge of their official activities (Minn. Stat. § 15.17). The Minnesota Government Data Practices Act, (the "Act") states that a government agency can collect only information that is necessary for the administration and management of programs specifically authorized by the legislature, local governing body (i.e., city council, county board, etc.) or mandated by the federal government. (Minn. Stat. § 13.05, subd. 3). This authorization is called the enabling authority, Examples of "programs" are: building code enforcement, Community Block Development Grant program, liquor licensing. All of these programs are established by and implement a federal, state or local law. 3. The information that the City collects must be accurate, complete and current for the purposes for which it was collected. At any time, a data subject may contest the accuracy and completeness of the data the city maintains about him or her. Minn. Rules, Part 1205.1500 defines the terms: a. "Accurate" to mean that the data in question is reasonably correct and free from error', b. "Complete" to mean that the data in question reasonably reflects the history of an individual's transactions with the particular entity. Omissions in an individual's history that place an individual in a false light are not permitted; and C. "Current" to mean that the data in question must be logically related to the entity's required and actual use of the data in its day-to-day operations. (Minn. Rules, Pt. 1205.1500, subp. 2) CAH50884 GA115-26 2 B. Determining What Information Is "Necessary". The Act provides that the "[c)ollection and storage of all data on individuals and the use and dissemination of private and confidential data... shall be limited to that necessary for the administration and management of programs..." (Minn. Stat, § 13.05, subd. 3) The Responsible Authority determines what is "necessary" for the administration and management of authorized programs based on criteria contained in Minn. Rules, Part 1205.1500 of the "Rules Governing the Enforcement and Administration of the 'Minnesota Government Data Practices Act."' These Rules state that data is necessary if: 1. the particular data is both required to carry out programs or functions that are expressly or impliedly authorized by a provision of state statute, federal law or a local ordinance and periodically examined, updated, modified or referred to by the entity; or 2. the entity would be unable to fulfill its duties without undue or increased burden, if the particular data were not collected, stored, used or disseminated; or 3. retention of the particular data is required in the event that a legal action is brought against or by the entity; or 4. retention of the particular data is essential to comply with a state or federal requirement that data be retained for a specified peci ied period for the purposes of auditing, records retention, historical interest, and other similar purposes. (Minn. Rules, Pt. 1205.1500, subp. 4) C. Retention and Disposition of Government Data 1. The destruction, preservation and reproduction of government data is largely regulated by Minnesota Statutes, Chapter 138 (see Minn. Stat. §§ 138-161-138.25). While some records must be kept for a period prescribed by law, such as certain child abuse reports, a specific retention period for many records is not prescribed by law. Absent a clearly specified retention period, the records, with few exceptions, may be disposed of only after the Records Disposition Panel approves a Records Retention Schedule or an application to dispose of records. The Records Disposition Panel is composed of the Attorney General, Legislative or State Auditor and the Director of the Minnesota Historical Society. The panel has the power, by unanimous consent, to direct the destruction, sale or other disposition of government records. The destruction of government records without the proper authority is a misdemeanor (Minn. Stat. § 138.225). CAH50884 GAIIS-26 3 2. The City has adopted a Records Retention Schedule, which must be updated at least bi- annually by the Responsible Authority. City employees must dispose of records in accordance with the Records Retention Schedule. If a record does not appear in the Records Retention Schedule, the department head should notify the Responsible Authority. Proposed revisions to the Records Retention Schedule must be referred to the Responsible Authority. 3. The Responsible Authority must keep records containing government data in such an arrangement and condition as to make them easily accessible for convenient use. Photographic, photostatic, microphotographic, or microfilmed records shall be considered as accessible for convenient use regardless of the size of such records. Every department head is designated to perform the Responsible Authority's obligations under this paragraph with regard to records maintained in his or her respective department. (Minn. Stat. § 13.03, subd. 1) CAH50884 GA115-26 4 For the purposes of these guidelines, government data is divided into three types: (a) data on individuals, which is classified as either public, private, private data on decedents, confidential, or confidential data on decedents; (b) data not on individuals, which is classified as either public, nonpublic or protected nonpublic, and (c) statistical or summary data derived from data on individuals. All government data is presumed to be public unless a state statute, temporary classification or federal law (includes federal rules and federal court decisions) classifies the data as not public. The classifications, the criteria for classification and the description of who has access are contained in the following: IA. Public Data on Individuals I 1. Definition. Public data on individuals means data on individuals, living or dead, which is accessible to the public. (Minn. Stat. § 13.02, subd. 15) Data on individuals means data in which a natural person is or can be identified as the subject of the data, unless the appearance of the name or other identifying data is clearly incidental to the data and the data is not accessed by the name or other identifying data of any individual. (Minn. Stat. § 13.02, subd. 5) 2. Data on Individuals Is Public If: a. A statute or federal law substantially requires that certain data on individuals be made available to the public. b. A state, local or federal law requires the collection of data on individuals and a statute or federal law does not classify the data private or confidential. C. The data is collected without any specific enabling authority to do so and is not classified by either state statute or federal law even though the data is necessary for administration and management. d. An application for temporary classification for private or confidential data on individuals is disapproved or rejected by the Commissioner of Administration or the Attorney General. e. A temporary classification or statutory classification expires. f. The data is summary or statistical data derived from private or confidential data on individuals and the summary or statistical data is not classified by state statute or federal law as "not public." (See Section 6, "Summary Data".) CAH50884 GA115-26 5 91 Private or confidential data becomes public in order to comply with either judicial or administrative rules pertaining to the conduct of legal actions (for example, private or confidential data presented in court and made public by the court). (Minn. Stat. § 13.03, subd. 4) 3. Access. Public data on individuals is accessible to the public regardless of their interest in the data. (Minn. Stat. § 13.05, subd. 3; Minn. Rules, Pt. 1205.0300, subp. 2) IB. Private Data on Individuals 1. Definition. Private data on individuals is data which is not accessible to the public but is accessible to the individual subject of the data. (Minn. Stat. § 13.02, subd. 12) 2. Data on Individuals Is Private If: a. A state statute or federal law expressly classifies the data as not accessible to the public but accessible to the individual subject of the data. (Minn. Rules, Pt. 1205.0200, subp. 9) b. A "Temporary Classification" of private has been approved by the Commissioner of Administration and has not expired or been disapproved by the Attorney General. (Minn. Stat. § 13.06) C. A state statute, federal law or temporary classification classifies the data as private data on individuals in the hands of the agency from which the City received the data. (Minn. Stat. § 13.03, subd. 4) d. A state statute or federal law classifies the data as "confidential" but makes the data available to the individual subject of the data. (Minn. Rules, Pt. 1205.0200, subp. 9) e. The data is classified as both private and confidential. (Minn. Stat. § 13.03, subd. 4) 3. Access. Private data on individuals is accessible to: a. The individual subject of the data. (Minn. Rules, Pt. 1205.0400, subp. 2) b. In the case of a minor or an individual adjudged mentally incompetent, a parent or guardian or, in the absence of a parent or guardian, an individual acting as a parent or guardian, unless otherwise provided by law. (See Section 10) (Minn. Stat. § 13.02, subd. 8) C. Individuals, entities or persons given express written permission by the data subject. (See Section 5, "Informed Consent") (Minn. Stat. § 13.05, subd. 4(d)) CM50884 CA115-26 6 d. Personnel within the entity whose work assignment reasonably requires access, as determined by the Responsible Authority or the designee. (Minn. Rules, Pt. 1205.0400, subp. 2) e. Individuals, entities or persons who are authorized by state, local or federal law to gain access. (Minn. Rules, Pt. 1205.0400, subp. 2) f. Individuals, entities or persons who used, stored and disseminated government data collected prior to August 1, 1975 with the condition that use, storage and dissemination was not accessible to the public but accessible to the data subject. Use, storage and dissemination of this data is limited to the purposes for which it was originally collected. (Minn. Stat. § 13.05, subd. 4(a)) 9- Individuals or agencies specifically authorized access to the data by a state, local or federal law enacted after the collection of the data. (Minn. Stat. § 13.05, subd. 4(b)) h. Individuals, entities or persons subsequent to the collection of the data and subsequent to the communication of the "Tennessen Warning" when specifically approved by the Commissioner of Administration as necessary to carry out a function assigned by law. (See Section 4.A.5.) (Minn. Stat. § 13.05, subd. 4(c)) A court, pursuant to a court order. (Minn. Stat. § 13.03, subds. 4 and 6) 4. Tennessen Warning. A Tennessen Warning (see Section 4) must be given when private data is collected from the subject of the data. A Tennessen Warning is not given when private data is collected (1) from someone other than the subject of the data, (2) when an individual is asked to supply investigative data to a law enforcement officer, or (3) when an individual volunteers private or confidential data about him/herself without being asked. (Minn. Stat. § 13.04, subd. 2) IC. Private Data on Decedents, I. Definition. Private data on decedents means data which, prior to the death of a data subject, were classified by statute, federal law, or temporary classification as private data. (Minn. Stat. § 13.10) 2. Data on Decedents Is Private If: a, Prior to, the death of an individual: (1) A state statute or federal law expressly classifies the data as not accessible to the public but accessible to the individual subject of the data. (Minn. Rules, Pt. 1205.0200, subd. 9) CAH50BB4 GAIIS-26 7 (2) A "Temporary Classification" of private has been approved by the Commissioner of Administration and has not expired or been disapproved by the Attorney General. (Minn. Stat. § 13.06) (3) A state statute, federal law or temporary classification classifies the data as private data on individuals in the hands of the agency from which the City received the data. (Minn. Stat. § 13.03, subd. 3) (4) A state statute or federal law classifies the data as "confidential" but makes the data available to the individual subject of the data. (Minn. Rules, Pt. 1205.0200, subp. 9) b. A state statute, federal law or temporary classification provides that data on a deceased individual is private. 3. Access. Private data on decedents is accessible to: a. The representative of the decedent after presenting sufficient documentation to prove that the subject of the data is deceased and that the individual requesting access is the bona fide representative of the decedent. (Minn. Stat. § 13.10) b. A trustee appointed in a wrongful death action. (Minn. Stat. § 13.10) C. Personnel within the entity whose work assignment reasonably requires access, as determined by the Responsible Authority or designee. (Minn. Rules, Pt. 1205.0400, subp. 2) d. Individuals, entities or persons given express written permission by the data subject or the representative of the decedent. (Minn. Stat. § 13.05, subd. 4(d)) e. Individuals, entities or persons who are authorized by state, local or federal law to gain access. (Minn. Rules, Pt. 1205.0400, subd. 2) f. Individuals or agencies specifically authorized access to the data by a state, local or federal law enacted after collection of the data. (Minn. Stat. § 13.05, subd. 4(b)) 9. Individuals, entities or persons subsequent to the collection of the data when specifically approved by the Commissioner of Administration as necessary to carry out a function assigned by law. (See Section 4.A.5.) (Minn. Stat. § 13.05, subd. 4(c)) h. A court, pursuant to a court order. (Minn. Stat. §§ 13. 10, subd. 4; 13.03, subds. 4 and 6) CM508 84 GA115 - 26 8 4. Evidence of Death. Evidence of death may include but is not limited to: a. The death certificate or copy; b. A publication of death (e.g., obituary in the local newspaper); or C. Funeral card. 5. Representative of the Decedent. a. The "representative of the decedent" is: (1) The personal representative of the estate during the period of administration; (2) If there is no personal representative of the estate or after discharge of the personal representative, the spouse or any child of the decedent or, if there is no surviving spouse or children, the parents of the decedent. (Minn. Stat. § 13.10, subd. l(c)) b. Documentation of the representative of the decedent may include: (1) Letters of administration appointing the individual as the administrator of the estate. (2) Any documentation that establishes kinship. This may include but is not limited to birth certificate, death certificate, baptism record, school records, marriage license, church records, military record, social security record, probate record, adoption record, divorce records and immigration records. C. Rights conferred on subjects of private and confidential data shall be exercised by the representative of the decedent. Many of these rights are contained in Exhibit A. 6. Expiration of Classification. Private data on decedents is public 10 years after the actual or presumed death of the data subject and 30, years after the creation of the data. An individual is presumed to be dead 90 years after the creation of the data or 90 years since the individual's birth, whichever is earlier, unless there is readily available data to indicate that the data subject is still living. (Minn. Stat. § 13.10, subd. 2) D. Confidential Data on Individuals. 1. Definition. Data on individuals is confidential if it is made by statute or federal law not accessible by the public and not accessible to the individual subject of the data. (Minn. Stat. § 13.02, subd. 3) CM150884 GA115-26 9 2. Data on Individuals Is Confidential If: a. A state statute or federal law expressly provides that: (1) the data shall not be available to either the public or to the data subject or (2) the data shall not be available to anyone except those agencies which need the data for agency purposes. (Minn. Rules, Pt. 1205.0200, subp. 3) b. A "Temporary Classification" of confidential has been approved by the Commissioner of Administration and has not expired or been disapproved by the Attorney General. (Minn. Stat. § 13.06) 3. Data on Individuals Is Not Confidential If. a. A state statute or federal law classifies the data as confidential but allows access to the subject of the data. The classification is then private. b. The data is classified as both private and confidential by the Act or any other statute or federal law. The classification of the data is then PRIVATE. (Minn, Stat. § 13.03, subd. 4) 4. Access. Confidential data on individuals is accessible to: a. Entities or agencies who are authorized by state, local or federal law to gain access. (Minn. Rules, Pt. 1205.0600, subp. 2) b. Personnel within the entity whose work assignment reasonably requires access, as determined by the Responsible Authority or designee. (Minn. Rules, Pt. 1205.0600, subp. 2) C, Individuals, entities or persons who used, stored and disseminated government data collected prior to August 1, 1975 with the condition that the data was not accessible to the individual subject of the data. Use, storage and dissemination of this data is limited to the purposes for which it was originally collected. (Minn. Stat. § 13.05, subd. 4(a)) d. Individuals or agencies specifically authorized access to the data by a state, local or federal law enacted after collection of the data. (Minn. Stat. § 13.05, subd. 4(b)) e. Individuals, entities or persons subsequent to the collection of the data when specifically approved by the Commissioner of Administration as necessary to carry out a function assigned by law. (See Section 4.A.5.) (Minn. Stat. § 13.03, subd. 4(c)) A court, pursuant to a court order. (Minn. Stat. § 13.03, subds. 4 and 6) =50884 GA115 - 26 10 5. Tennessen Warning. A Tennessen Warning (See Section 4) must be given when confidential data is collected from the data subject. A Tennessen Warning is not given when private data is collected (1) from someone other than the subject of the data, (2) when an individual is asked to supply investigative data to a law enforcement officer, or (3) when an individual volunteers private or confidential data about him/herself without being asked. (Minn. Stat. § 13.04, subd. 2) IE. Confidential Data on Decedents. 1. Definition. Confidential data on decedents means data which, prior to the death of the data subject, were classified by statute, federal law, or temporary classification as confidential data. (Minn. Stat. § 13.10) 2. Data on Decedents Is Confidential If: a. Prior to the death of an individual: (1) A state statute or federal law expressly provides that: (a) the data shall not be available to either the public or to the data subject or (b) the data shall not be available to anyone except those agencies which need the data for agency purposes. (Minn. Rules, Pt. 1205.0200, subp. 3) (2) A "Temporary Classification" of confidential has been approved by the Commissioner of Administration and has not expired or been disapproved by the Attorney General. (Minn. Stat. § 13,06) b. A state statute, federal law or temporary classification provides that data on a deceased individual is confidential. 3. Access. Confidential data on individuals is accessible to: a. Entities or agencies who are authorized by state, local or federal law to gain access. (Minn. Rules, Pt. 1205.0600, subp. 2) b, Personnel within the entity whose work assignment reasonably requires access, as determined by the Responsible Authority or designee. (Minn. Rules, Pt. 1205.0600, subp. 2) C. Individuals, entities or persons who used, stored and disseminated government data collected prior to August 1, 1975 with the condition that the data was not accessible to the individual subject of the data. Use, storage and dissemination of this data is limited to the purposes for which it was originally collected. (Minn. Stat. § 13.05, subd. 4(a)) CAH50984 GA115-26 d. Individuals or agencies specifically authorized access to the data by a state, local or federal law enacted after collection of the data. (Minn. Stat. § 13.05, subd. 4(b)) e. Individuals, entities or persons subsequent to the collection of the data when specifically approved by the Commissioner of Administration as necessary to carry out a function assigned by law. (See Section 4.A.5.) (Minn. Stat. § 13.03, subd. f. A court, pursuant to a court order. (Minn. Stat. §§ 13.10; 13.03, subds. 4 and 6) 4. Expiration of Classification. Confidential data on decedents is public 10 years after the actual or presumed death of a data subject and 30 years after the creation of the data. An individual is presumed to be dead 90 years after the creation of the data or 90 years since the individual's birth, whichever is earlier, unless there is readily available data that the data subject is still living. (Minn, Stat. § 13. 10, subd. 2) F. Summary Data 1. Definition. Summary data means statistical records and reports derived from data on individuals but in which the individuals are not in any way identifiable. (Minn. Stat. § 13.02, subd. 19) 2. Data Is Summary If - a. All data elements that could link the data to a specific individual have been removed, and b. Any list of numbers or other data which could uniquely identify an individual is separated from the summary data and is not available to persons who gain access to or possess summary data. (Minn. Rules, Pt. 1205.0200, subd. 16) 1 Access. Unless classified by a "Temporary Classification", another statute or federal law, summary data is public and may be requested by and made available to any individual or person. (Minn. Stat. § 13.05, subd. 7) Note: Further information regarding requests for summary data is contained in Section 6. IG. Public Data Not on Individuals I 1. Definition. Public data not on individuals means data not on individuals which is accessible to the public. (Minn. Stat. § 13.02, subd. 14) CAH50684 GA115-26 12 2. Data Not on Individuals Is Public If: a. No statute, federal law, or Temporary Classification expressly classifies the data as "not public". (Minn. Stat. §§ 13.01, subd. 3; 13.03, subd. 1) b. An application for "Temporary Classification" for data as "'nonpublic" or "protected nonpublic" is disapproved by the Commissioner of Administration or the Attorney General, (Minn. Stat. § 13.06, subd. 5) C. A statute or federal law substantially requires the data to be made available to the public. d. The data is collected without any enabling authority to do so and is not classified as nonpublic or protected nonpublic by either statute or federal law. 3. Access. Public data not on individuals is accessible to the public regardless of their interest in the data. (Minn. Stat. § 13.05, subd. 3; Minn. Rules, Pt. 1205.0300, subp. 2) IH. Nonpublic Data Not on Individuals 1. Definition. Nonpublic data not on individuals means data not on individuals which is not public but is accessible to the subject of the data, if any. As used here the "subject of the data" means a partnership, corporation, etc. (Minn. Stat. § 13.02, subd. 9) 2. Data Not on Individuals is Nonpublic If: a. A state statute or federal law classifies the data as not public but accessible to the subject of the data, if any. (Minn. Stat. § 13.02, subd. 9) b. A "Temporary Classification" of data as nonpublic has been approved by the Commissioner of Administration and has not expired or been disapproved by the Attorney General. (Minn. Stat. § 13.06) 3, Access. Nonpublic data not on individuals is accessible to: a. The subject of the data, if any. (Minn. Stat. § 13.02, subd. 9) b. Personnel within the entity whose work assignment reasonably requires access, as determined by the Responsible Authority or designee. c. Individuals, entities or persons authorized by state statute or federal law to again access. d. A court, pursuant to a court order. C. Individuals, entities or persons as otherwise provided for by law. CM50884 GAIIS-26 13 4. Expiration of Classification. Except for security information, nonpublic data shall become public 10 years after the data was created, collected or received by the government agency. However, if the Responsible Authority determines that harm to the public or to a data subject outweighs the benefit to the public, then the Responsible Authority may deny access. The requester may seek court action. (Minn. Stat. § 13.03, subd. 8) I. Protected Nonpublic Data Not on Individuals. 1. Definition. Protected nonpublic data not on individuals means data which is not public and not accessible to the subject of the data. (Minn. Stat. § 13.02, subd. 13) 2. Data Not on Individuals Is Protected Nonpublic If: a. A state statute or federal law classifies the data as not accessible to the public and not accessible to the data subject. (Minn. Stat. § 13.02, subd. 13) b. A "Temporary Classification" of government data as protected nonpublic has been approved by the Commissioner of Administration and has not expired or been disapproved by the Attorney General. (Minn. Stat, § 13.06) 3. Access. Protected nonpublic data not on individuals is accessible to: a. Personnel within the entity whose work assignment reasonably requires access, as determined by the Responsible Authority or designee. b. Individuals, entities or persons authorized by statute or federal law to gain access. C. A court, pursuant to a court order. d. Individuals, entitles or persons as otherwise provided for by law. 4. Expiration of Classification. Except for security information, protected nonpublic data shall become public 10 years after the data was created, collected or received by the government agency. However, if the Responsible Authority determines that harm to the public or to a data subject outweighs the benefit to the public, then the Responsible Authority may deny access. The requestor may seek court action. (Minn. Stat. § 13.03, subd. 8) CM50884 GA115-26 14 SECTION 3 flu tTOW n_I Unless a state statute or federal law expressly classifies government data as not public data (i.e., private, confidential, nonpublic or protected nonpublic), the data is public and accessible to anyone. The Temporary Classification system was put into the Act as a means to classify data when an agency has a compelling reason to protect the data and a state statute or federal law does not expressly do so. A Temporary Classification may be defined as an application made by a state agency, statewide system or political subdivision and approved by the Commissioner of Administration and the Attorney General, which temporarily classifies government data as private or confidential data on individuals, or nonpublic or protected nonpublic data not on individuals. (Minn. Stat. § 13.06) The Temporary Classification process begins with an application to the Commissioner of Administration. Two sample application forms are contained in Exhibits B and C. One of the forms is an application to classify data on individuals as either private or confidential, and the second form is an application to classify data not on individuals as either nonpublic or protected nonpublic. A. Temporary Classification for Data on Individuals. An application for a Temporary Classification of private or confidential for data on individuals must establish that: 1. no statute or federal law currently exists which either allows or forbids classification as private or confidential; and 2. either: a. similar data has been treated as either private or confidential by other state agencies or, political subdivisions and by the public; or b. a compelling need exists for immediate Temporary Classification which if not granted could adversely affect the public interest or the health, safety, well-being or reputation of the data subject. (Minn. Stat. § 13.06, subd. 2) CARS0884 GA115-26 15 B. Temporary Classification for Data Not on Individuals. An application for a Temporary Classification of nonpublic or protected nonpublic for data not on individuals must establish that: 1. no statute or federal law currently exists which either allows or forbids classification as nonpublic or protected nonpublic; and 2. either: a. similar data has been treated as nonpublic or protected nonpublic by other agencies or political subdivisions and the public; or b. public access to the data would render unworkable a program authorized by law; or C. a compelling need exists for immediate Temporary Classification which if not granted could adversely affect the health, safety, or welfare of the public. (Minn. Stat. § 13.06, subd. 3) C. Determination of the Commissioner of Administration Upon receiving the application, the Commissioner of Administration, as well as the Attorney General and the legislature, may make one of several determinations: 1. Upon application to the Commissioner of Administration, the data is classified as requested by the application for 45 days or until the application is disapproved, rejected or granted by the Commissioner of Administration, whichever is earlier. If the Data Privacy Division requires additional information in support of the application the application is deemed to have been filed on the date that the additional information is received by the Data Privacy Division, (Minn. Stat. § 13.06, subd. 1; Minn. Rules, Pt. 1205.1800, subp. 3) 2. If the Commissioner determines that an application has been submitted for reasons not consistent with the Act, s/he may immediately reject the application and the data shall have the same classification it had before the application. (Minn. Stat. § 13.06, subd. 1) 3. The Commissioner may consider broadening an agency's application for Temporary Classification so that it has statewide effect. In this case, the data is classified as requested for a period of up to 90 days. (Minn. Stat. § 13.06, subd. 4) 4. The Commissioner may grant a Temporary Classification of government data as either private or confidential for data on individuals or nonpublic or protected nonpublic for data not on individuals. A Temporary Classification which is granted by the Commissioner is effective immediately and the record effecting the approval is sent to the Attorney General. (Minn. Stat. § 13.06, subd. 5) CAH50884 GA115-26 16 5. The Attorney General has 25 days to approve the classification granted by the Commissioner, approve a change in classification from confidential to private, or disapprove the classification. If the Attorney General disapproves a classification, the data becomes public 5 working days after the date of disapproval. (Minn. Stat. § 13.06, subd. 5) 6. On or before January 15 of each year, the Commissioner shall submit all Temporary Classifications in effect on January I in bill form to the legislature. (Minn. Stat. § 13.06, subd. 7) 7. Data which the Commissioner disapproves for Temporary Classification becomes public data 20 days after the date of disapproval. (Minn. Stat. § 13.06, subd. 5) 8, An amended application may be filed, requesting the classification deemed appropriate by the Commissioner in a previous statement of disapproval, or setting forth additional information relating to the original application. Data on such an amended application will be classified as requested for a period of 20 days or until the Commissioner grants or disapproves the request. If the amended application is disapproved, the data becomes public 5 working days after the date of the Commissioner's disapproval. (Minn. Stat. § 13.06, subd. 5) 9. A Temporary Classification which is not enacted into law by the legislature shall expire 10 days after the end of the second complete regular session that follows the Commissioner's granting of the Temporary Classification. (Minn. Stat. § 13.06, subd. 6) D. Application for Temporary Classification. 1. All requests for Temporary Classification must be approved by the Responsible Authority and city administrator before any application is submitted to the Commissioner of Administration. 2. The application forms contained in Exhibits B and C may be copied and used IF you FIRST check with the State's Data Privacy Division to be sure that these forms are the latest revision. The application forms contain the necessary instructions for their completion. If any questions arise regarding the application, contact the Data Privacy Division at (612) 296-6733. IE. Recordkeeping Requirements I If an application for Temporary Classification is granted, the Responsible Authority will provide a copy of the notice of approval to every department head for distribution to department employees. The Responsible Authority will maintain a record of each application for Temporary Classification, whether the application was granted or denied, and the expiration date of each granted application. CAH50684 GA115-26 17 RM"Ifelar'] A. Tennessen Warning - Rights of Subjects of Data. The Minnesota Government Data Practices Act provides every individual from whom the City collects private or confidential data with certain rights. These rights include information that is to be communicated to the individual prior to collecting private or confidential information from him or her. 1. Every department that asks an individual to supply private or confidential data concerning him/herself shall, prior to collecting the data, inform the individual of his/her rights as a subject of data. These rights include the Tennessen Warning which is one of the fundamental requirements of the Act. 2. A Tennessen Warning is required when: an individual; is asked; to supply; private or confidential data; concerning himself or herself. 3. A Tennessen Warning is not required: a. when collecting public data on an individual; b. when private and confidential data is collected from an individual who is not the subject of the data (i.e., an individual giving information on someone else); C. when an individual is asked to supply investigative data to a law enforcement officer pursuant to Minnesota Statutes, Section 13.82, Subdivision 5 (Minn. Stat. § 13.04, subd. 2); or d. when an individual volunteers private or confidential information about him/herself without being asked. 4. Contents of Tennessen Warning. The Tennessen Warning consists of the following information that must be communicated to the individual from whom private or confidential data concerning him/herself is collected: CAH50884 GA115-26 18 a. the purpose and intended use of the requested private or confidential data within the City; b. whether the individual may refuse or is legally required to supply the requested private or confidential data; C. any known consequences arising from the individual's supplying private or confidential data; or d. any known consequences arising from the individual's refusing to supply private or confidential data; and e. the identity of other persons or entities authorized by state or federal law to receive the data. (Minn. Stat. § 13.04, subd. 2) NOTE: Unless otherwise provided for by law (e.g., education and medical data), the Responsible Authority or designee must provide minors from whom private or confidential data is collected with a notification that the minor individual has the right to request that parental access to the private data be denied. This notification should be in writing and may be contained on the Tennessen Warning. (See Section 10, "Parental Access to Data on Minors") (Minn. Rules, Pt. 1205.0500, subp. 3.A.) NOTE: In accordance with the Federal Privacy Act of 1974, "any Federal, State, or local government agency which requests an individual to disclose his social security account number shall inform that individual whether that disclosure is mandatory or voluntary, by what statutory or other authority such number is solicited and what uses will be made of it." (See Section 14, "Use of the Social Security Number") 5. Restrictions on Use of Data. Private and confidential data may not be collected, stored, used or disseminated for any purpose other than those stated to the individual in the Tennessen Warning, except: a. data collected prior to August 1975 may be used for the purposes for which it was originally collected or for new purposes specifically approved by the Commissioner of Administration; K data may be used and disseminated to individuals or agencies specifically authorized access to the data by a state, local or federal law enacted after the data was collected-, C. data for which the Commissioner of Administration has specifically approved a new use or dissemination to carry out a function assigned by law; and d. data for which the individual subject of the data has given his/her informed consent, (See Section 5, "Informed Consent") (Minn. Stat. § 13.05, subd. 4) CAH50884 GA115-26 19 A request for Commissioner approval under paragraphs 4.a. or 4.c. may only be filed by the Responsible Authority with the consent of the city administrator. B. Administering Tennessen Warnings 1. Depending upon the sensitivity of the information collected or the sensitivity of an individual to personal privacy, Tennessen Warnings may be: a. An oral communication. This is not the preferred method of communicating the Tennessen Warning, and it may be used only when necessary under the circumstances (i.e., collecting private or confidential data over the telephone). If an oral communication is necessary, the specific language communicated must be in written form (for example, a card from which a city staff person reads the "Warning"). b. A written communication requiring the signature of the data subject (i.e., a signature attesting that the individual from whom private or confidential data is collected has read and understands his rights as a subject of data). C. A written communication not requiring a signature. This may be, for example, a brochure, booklet, pamphlet or a single sheet which is handed to the individual prior to collecting the data. 2. Whenever possible, the Tennessen Warning should be included on the form that collects the private or confidential data. 3. A copy of the Tennessen Warning administered to the data subject should be included in the data subject's file. If the Tennessen Warning is given orally or given in written form that does not require the data subject's signature, the person who administered the warning must sign and date the form used. IC. Preparing Tennessen Warning Forms 1. Use the "Tennessen Warning Development Worksheet" (Exhibit D) when developing a Tennessen Warning for private and confidential records. 2. If the private or confidential information is collected from a minor (under 18 years of age), provide the "Minor Notification" described in Section 9. 3. Add the following "Rights of Subjects of Data" to your Tennessen Warning, either on the same form as the warning or on a separate sheet. a. You have the right to be informed, upon request, whether you are a subject of government data and the classification of that data. (Minn. Stat. § 13.04, subd. 3) CANSOB84 GA115-26 20 b. You have the right to be shown any public and private information we have on you at no charge. (Minn. Stat. § 13,.04, subd. 3) C. You have the right to have copies of any public and private information we have on you but you may be charged a reasonable fee. (Minn. Stat. § 13.04, subd. 3) d. We will provide copies of the requested data about you immediately, if possible, or within 5 working days. If we cannot provide the data in 5 working days we will notify you of this and we will provide the data within another 5 working days. (Minn. Stat. § 13.04, subd. 3) e. You have the right to contest the accuracy and completeness of any public or private data we have on you. (Minn. Stat. 13.04, subd. 4) f. You have the right to appeal any decision we make about your records. (Minn. Stat. § 13.04, subd. 4) 4. All Tennessen Warning forms must be approved by the Responsible Authority before use. The Responsible Authority must maintain copies of all approved forms currently in use. 5. A sample Tennessen Warning is contained in Exhibit E. CAH50884 GA115-26 21 A. Why and When Informed Consent is Needed 1. In general, private data on an individual may be collected, stored, used and disseminated only for those purposes stated to the individual data subject at the time the data was collected. (See Section 4, "Tennessen Warning") (Minn. Stat. § 13.04, subd. 4) 2. However, private data on individuals may be used by and disseminated to any individual or agency by the Responsible Authority or the designee if the individual subject or subjects of the data have given their informed consent (Minn. Stat. § 13.05, subd. 4(d)). NOTE: Except when expressly provided for by law, informed consent cannot authorize a new purpose or a new use of confidential data on individuals. 1 An informed consent or authorization for the release of information is needed in order to: a. use private data for a purpose that was not stated to the individual data subject in the Tennessen Warning given at the time the data was collected; or b. provide access to private data to a person, entity or agency other than those stated to the individual data subject in the Tennessen Warning given at the time the data was collected. 4. An informed consent is not needed: a. to use private data on individuals for any lawful purpose which was communicated to the subject of the data on the Tennessen Warning at the time the data was collected; b. when a new use or dissemination is specifically authorized by a federal, state or local law enacted after the data was collected (Minn. Stat. § 13.05, subd. 4(b)), or C. when the Responsible Authority has requested and received approval from the Commissioner of Administration for a new or different use or dissemination of the data (Minn. Stat. § 13.05, subd. 4(a) and (c)). (See Section 4.A.5.) CAHS0664 GAII5-26 22 IB. Requirements for Informed Consent 1. All informed consents must be in writing on a form provided by the City and approved by the Responsible Authority. The informed consent form must describe the necessity for or consequences of the giving of informed consent, including the consequences of the new or different purpose or use of the data. Informed consents that are not on a City form may be accepted if the Responsible Authority determines that the consent provided is substantially similar to a City informed consent form. 2. An informed consent must be signed by the individual data subject or, in the case of a minor or a person adjudged mentally incompetent, by the data subject's parent or guardian or, in the absence of a parent or guardian, by the person acting as the parent or guardian. (Minn. Stat. § 13.02, subd. 8) 3. For data security reasons, the signature: of the data subject should be witnessed. If the signature is not witnessed, the Responsible Authority or designee must make reasonable attempts to verify the signature as belonging to the data subject. Reasonable attempts at verification include: a. the Responsible Authority or designee knows and recognizes the data subject's signature; or b. the Responsible Authority or designee compares the signature on the "Informed Consent" to other City records that contain the data subject's signature; or C, the Responsible Authority telephones the data subject, and the data subject confirms that s/he signed the "Informed Consent"; or d. the data subject personally appears before the Responsible Authority or designee, presents identification, and either signs the "Informed Consent" or verbally confirms that the signature on the "Informed Consent" is his/hers. 4. No City employee shall take any action to coerce any data subject to give an informed consent. (Minn. Rules, Pt. 1205.1400, subp. 4.A.) 5. Informed consent shall not be deemed to have been given by an individual subject of the data by the signing of any statement authorizing any entity or person to disclose information about him or her to an insurer or its authorized representative, unless the statement is: a. in plain language; b. dated; C. specific in designating the particular persons or agencies the data subject is authorizing to disclose information about him or her; CAH50684 GA115-26 23 d. specific as to the nature of the information s/he is authorizing to be disclosed; e. specific as to the persons or entities to whom s/he is authorizing information to be disclosed; f. specific as to the purpose or purposes for which the information may be used by any of the parties named in clause (c), both at the time of the disclosure and at any time in the future; 9. specific as to its expiration date which should be within a reasonable period of time, not to exceed one year except in the case of authorizations given in connection with applications for life insurance or non -cancelable or guaranteed renewable health insurance and identified as such, two years after the date of the policy. (Minn. Stat. § 13.05, subd. 4(d); Minn. Rules, Pt. 1205.1400, subp. 5) 6. An example of an "Informed Consent" form is contained in Exhibit F. IC. Implied Consent 1. The Responsible Authority may deem informed consent to have been given, even in the absence of a written consent signed by the data subject, under the following limited circumstances: a. informed consent is needed to authorize a new or different use of the data by the City; and b. the Responsible Authority or designee has made reasonable efforts to obtain the informed consent of the data subject but those efforts are not acknowledged in any way. (Minn. Stat. § 13.05, subd. 4 (d); Minn. Rules, Pt. 1205.1400, subp. 4.C.) 2. "Reasonable efforts" means: a. depositing in the United States mail, postage prepaid and directed to the last known address of the data subject, at least two communications requesting informed consent; and b. waiting for a period of not less than 60 days for a response to the second request. (Minn. Stat. § 13.05, subd. 4 (d); Minn. Rules, Pt. 1205.1400, subp. 4.C.) 3. Upon the expiration of the 60 day period, the Responsible Authority may interpret the silence of the data subject ject as the giving of an implied consent to the new or different purpose or use of the data, and the Responsible Authority may implement the new or different purpose or use as though a signed consent had been received. (Minn. Stat. § 13.05, subd. 4 (d); Minn. Rules, Pt. 1205.1400, subp. 4.C.) CAR50884 GA115-26 24 NOTE: Implied consent may not be used to authorize the dissemination of private data to any person or entity not stated in the Tennessen Warning. Implied consent may be used only to authorize a new or different use or purpose for data within the City. CAH50884 GA115-26 25 IA. Requests for Summary Data. 1. Definition of Summary Data. "Summary data" means statistical records and reports derived from data on individuals but in which individuals are not identified and from which neither their identities nor any other characteristic that could uniquely identify an individual is ascertainable. (Minn. Stat. § 13.02, subd. 19.) 2. Classification. Unless classified by a state statute, federal law or temporary classification, summary data derived from private or confidential data on individuals is public. (Minn. Stat. § 13.05, subd. 7.) 3. Duty to Prepare. The Responsible Authority shall prepare the summary data upon the request of any person, if. (a) the request is in writing in a form provided by the City; and (b) the requesting person pays the cost of preparing the summary data. (Minn. Stat. § 13.05, subd. 7; Minn. Rules, Pt. 1205.0700) The Responsible Authority may delegate the power to prepare summary data to a City administrative officer responsible for any central repository of summary data or to a person outside of the City, including the requesting person, provided that the outside person signs a non -disclosure agreement, as described in paragraph 6 below. 4. Methods of Preparation. Methods of preparing summary data include but are not limited to the following: a. removing from a set of data, a file, or a recordkeeping system all unique personal identifiers so that the data that remains fulfills the definition of summary data as defined by the Act; and K removing from the entity's report of any incident, or from any collection of data similar to an incident report, all unique personal identifiers so that the resulting report fulfills the definition of summary data as defined by the Act. The phrase "removing all unique personal identifiers" includes but is not limited to blacking out personal identifiers on paper records, tearing off or cutting out the portions of paper records that contain the personal identifiers, and programming computers in such a way that printed, terminal, or other forms of output do not contain personal identifiers. (Minn. Rules, Pt. 1205.0700, subp. 6.) "Unique personal identifiers" means any data that identifies an individual in itself or can be used in connection with other data elements to uniquely identify an individual, including, but not limited to name, street address, job title, and so forth where the particular data could only describe or identify one individual. (Minn. Rules, Pt. 1205.0200, subp. 4.) CAHSOB84 GA115-26 26 5. Time for Response. Within 10 days of receipt of a request for summary data, the Responsible Authority or designee shall inform the requestor of the estimated costs of preparing the summary data, if any, and either: a. Provide the summary data requested; or b. Provide a written statement to the requestor, giving a time schedule for preparing the requested data, including reasons for any delays; or c. Provide access to the requestor to the private or confidential data so that the requestor can compile the summary data. Such access will be provided only when the requestor signs a nondisclosure agreement (see below); or d. Provide a written statement to the requestor stating reasons why the requestor's access would compromise the private or confidential data. (Minn. Rules, Pt. 1205.0700, subp. 4.) 6. Non -Disclosure Agreement. A non -disclosure agreement (see Exhibit P) must be obtained whenever the person who prepares the summary data is an "outside person," i.e., not a City employee. A non -disclosure agreement must contain at least the following: a. a general description of the private or confidential data which is being used to prepare summary data (Minn. Rules, Pt. 1205.0700, subp. 5); and b. the purpose for which the summary data is being prepared (Minn. Rules, Pt. 1205.0700, subp. 5); and C. a statement that the preparer understands s/he may be subject to the civil or criminal penalty provisions of the Act in the event that the private or confidential data is disclosed (Minn. Rules, Pt. 1205.0700, subp. 5); and d. a section in which the preparer agrees not to disclose data in any form that would identify or tend to identify an individual, and that he also agrees to defend and indemnify the City and any of its employees in any legal actions brought as a result of his/her having access to private or confidential data; and e. a description of the civil and criminal penalty provisions of the Act; and f the signature of the preparer and the Responsible Authority. 7. Costs of Preparing Summary ➢ata. The requesting person must pay all costs of preparing the summary data. a. The costs to be assessed include- (i) copy charges as set forth in Exhibit H, amended from time to time by the Responsible Authority; (ii) actual labor charges incurred by the City, which shall be determined by multiplying the hourly rate of the employee preparer times the total hours or portion thereof spent in preparing CAH50884 GA115-26 27 the summary data; (iii) any special costs necessary to produce copies from machine based record keeping systems, including but not limited to computers and microfilm systems; (iv) mailing costs; (v) costs or fees incurred when preparation of the summary data is referred to an outside person other than the requesting person. (Minn. Rules, Pt. 1205.0300, subp. 4; Pt. 1205.0700, subp. 7.) b. When the summary data being requested requires only copying and no other preparation, only reasonable copying costs may be charged. (Minn. Rules, Pt. 1205.0700, subp. 7.) C. If the summary data prepared has value to the City and the Responsible Authority deems it appropriate, the Responsible Authority shall determine the reasonable value of the summary data to the City and reduce the costs assessed to the requesting person. (Minn. Rules, Pt. 1205.0700, subp. 7.) d. The estimated cost of preparing the summary data must be collected from the requesting person prior to preparing the summary data. The requesting person must pay the balance of actual costs, if any, before the summary data will be provided to the requesting person. If the estimated cost paid by the requesting person exceeds the actual cost, the difference must be promptly refunded to the requesting person. CAH50584 GA115-26 28 IA. Requests for Data - General I This section establishes procedures for handling requests for access to and copies of government data. Generally, individual data subjects and persons other than data subjects have the following rights-, a. Upon request to a Responsible Authority, an individual must be informed whether the individual is the subject of stored data on individuals and whether the data is classified as public, private, or confidential. An individual data subject has the right to inspect and copy public or private data of which s/he is the subject and to be informed of the data's meaning. (Minn. Stat. § 13.04, subd. 3) b. Any person has the right to inspect and copy public data, regardless of the person's interest in the data. Upon request, any person requesting data has the right to be informed of the data's meaning. (Minn. Stat. § 13.03, subd. 3; Minn. Rules, Pt. 1205.0300, subp. 2) IB. Requests for Public Data 1. Scope, This Section 7.13 applies to all requests for public data except: a. requests for Summary Data. See Section 6, "Summary Data"; and b. requests for public data that is related to or requested by a party in litigation with the City or that is requested by subpoena. See Section TE. 2. Hours. Requests for access to public data must be made during normal business hours. (Minn. Rules, Pt. 1205.0300, subp. 3) 3. Who May Have Access. The Responsible Authority or designee must provide access to public data to any individual or entity who requests the data, without regard to the nature of that person's interest in the data. Access includes the right to inspect the data or to obtain copies. (Minn. Stat. § 13.03, subd. 3; Minn. Rules, Pt. 1205.0300, subp. 2) NOTE: A person who requests public data is not required to provide his or her name, address or other identifying information, and is not required to state his or her reason for requesting the data. CAH50884 GA115-26 29 4. Form of Request. Requests for access to public data may be made by telephone, in writing, or in person. In order to preserve efficient operation of City departments, each department head may establish limits on the number or types of requests to which the department will respond over the telephone. (E.g., a department head may establish a limit of only two questions per telephone call or may require that lengthy requests be submitted in writing.) (Minn. Rules, Pt. 1205.0300, subp. 3) Written requests are preferred and may be required by the Responsible Authority or designee. 5. Time for Response. Authorized City employees will respond to all requests for public data in a reasonably prompt manner. Whenever possible, the authorized City employees will immediately provide the requested information or allow the requesting person to inspect the public data. Where an immediate response would unreasonably interfere with the efficient performance of the City's operations, an authorized City employee may require that the requesting person make an appointment or return at a later time to inspect or to pick up copies of the requested data. Any delay in providing requested data must be reasonable in relation to the quantity of data requested, the time needed to retrieve and collect the requested data and, where applicable, the time needed to separate public from nonpublic data, compile copies, or certify copies. (Minn. Rules, Pt. 1205.0300, subp. 3) NOTE: When public data on individuals is requested by the individual data subject and an immediate response is not possible, authorized City employees must inform the data subject of the number of days needed to respond to the request, which may not exceed ten days from the date the request was received, excluding Saturdays, Sundays, and legal holidays. (Minn. Stat. § 13.04, subd. 3) 6, Denying Access. If the authorized city employee handling a request believes that the data is not public and that the requesting person is not entitled by law to have access to the data, the request will be handled in the manner provided in Section 7.17. 7. Fees. Fees may be charged only as provided in Section 9, "fees for copies of Government Data", 8. IDR Form Required. An Information Disclosure Request form must be completed if the person requests copies of public data on individuals. (See Section 8) C. Requests for Private Data on Individuals or Nonpublic Data Not on Individuals. 1. Scope. This Section TC applies to all requests for private data on individuals or nonpublic data not on individuals, except requests that are related to or made by a party in litigation with the City or that are requested by subpoena. See Section TE. 2. Hours. Requests for access to private data on individuals or nonpublic data not on individuals must be made during normal business hours. (Minn. Rules, Pt. 1205.0500, subp. 4) 3. Identities of Persons Requesting Access Must Be Verified. The Responsible Authority or designee may not provide access to private data on individuals or nonpublic data not on C-AH5 08 84 GA115-26 30 individuals to a person unless the requesting person provides reasonable assurance that the person is entitled to access. "Reasonable assurance"' includes: a. the requesting person appears at City offices and (1) the Responsible Authority or designee knows and recognizes the person as being the data subject or other person who by law is entitled to access; or (2) presents identification showing him/her to be the data subject or other person who by law is entitled to access; or (3) presents identification showing him/her to be a person designated to have access in an "Informed Consent" that meets the requirements of Section 5.B.; or (4) in the case of private data on a minor or individual adjudged mentally incompetent, presents identification showing him/her to be the parent of the data subject or presents a copy of a court order appointing him/her as guardian or conservator over the person or estate of the data subject; or (5) in the case of data on decedents, present identification and documentation showing him/her to be a representative of the decedent or trustee in a wrongful death action. (See Section 2.C.) MR b. the request is sent by mail and: (1) the Responsible Authority or designee knows and recognizes the data subject's signature on the request; or (2) the request is accompanied by an "Informed Consent" that meets the requirements of Section 5.B.; or (3) the Responsible Authority or designee verifies the signature on the request as that of the data subject by comparing the signature to other City records that contain the data subject's signature. 4. Government Access. a. The Responsible Authority or designee may allow other government agencies to have access to private data on individuals or nonpublic data not on individuals only when the access is authorized or required by statute or federal law. (Minn. Stat. § 13.05, subd. 9) b. Data has the same classification in the hands of the agency receiving it as it has in the hands of the agency providing it, unless the classification is required to CAH50884 GA115-26 31 change to meet judicial or administrative requirements. (Minn. Stat. § 13,03, subd. 4) When practical and necessary, the Responsible Authority or designee shall indicate the classification of not public data that the Responsible Authority or designee provides to a requesting goverment agency. C. When necessary, the agency requesting private data on individuals and not listed on the Tennessen Warning, should obtain informed consent from the data subject(s). 5. Time for Response. Authorized City employees will respond to all requests for nonpublic data not on individuals in a reasonably prompt manner. Whenever possible, the authorized City employees will immediately provide the requested information or allow the requesting person to inspect the public data. Where an immediate response would unreasonably interfere with the efficient performance of the City's operations, an authorized City employee may require that the requesting person make an appointment or return at a later time to inspect or to pick up copies of the requested data. (Minn. Rules, Pt. 1205.0300, subp. 3) NOTE: When private data on individuals is requested by the individual data subject and an immediate response is not possible, authorized City employees must inform the data subject of the number of days needed to respond to the request, which may not exceed ten days from the date the request was received, excluding Saturdays, Sundays, and legal holidays. (Minn. Stat. § 13.04, subd. 3) 6. Subsequent Requests by Individual Data Subject. After an individual data subject has been shown private data about himself or herself, the data need not be disclosed to that individual for six months thereafter unless a dispute or action pursuant to Minnesota Statutes, Section 13.04 is pending or unless additional data on the individual has been collected or created. (Minn. Stat. § 13.04, subd. 3) A request for access that is denied under this paragraph shall be handled in the manner provided in Section TF. 7. Denying Access. If the employee handling a request believes that the requesting person is not entitled by law to have access to the data, the request will be handled in the manner provided in Section TF. 8. Fees. Fees may be charged only as provided in Section 9, "fees for copies of Government Data". 9. IDR Form Required. An "Information Disclosure Request" form (see Section 8) must be completed for each request for not public data, except: a. In cases where private or nonpublic data is routinely shared with the data subject, the designee may, with the approval of the Responsible Authority, elect not to complete the "Information Disclosure Request" form for each request. Private or nonpublic data may not be released to the data subject over the telephone unless the authorized employee recognizes the voice of the requesting person as belonging to the data subject. CAH50884 GA115-26 32 b. No form is required where private or nonpublic data is routinely shared with or provided to an authorized government entity in the normal course of business. Private or nonpublic data may not be released over the telephone to a person representing themselves to be with a government entity authorized to have access unless: (1) the authorized employee recognizes the voice of the requesting person as that of a government employee authorized to have access; or (2) the authorized employee placed the telephone call to the government entity. (Minn. Rules, Pt. 1205.0500, subp. 3) D. Requests for Confidential Data on Individuals or Protected Nonpublic Data Not on Individuals. 1. Scope. This Section 7.D applies to all requests for confidential data on individuals or protected nonpublic data not on individuals, except requests related to or made by a party in litigation with the City or that is requested by subpoena. See Section TE. 2. Hours. Requests for access to confidential data on individuals or protected nonpublic data not on individuals must be made during normal business hours. (Minn. Rules, Pt. 1205.0500, subp. 4) 3. Access by Individuals. The Responsible Authority or designee may not provide access to confidential data on individuals or nonpublic data not on individuals to any person except those authorized by law to have access. (See Section 2.D.4.) The Responsible Authority or designee shall seek the advice of the city attorney before responding to any request by an individual for confidential data on individuals or nonpublic data not on individuals. 4. Government Access. a. The Responsible Authority or designee may allow other government agencies to have access to confidential data on individuals or protected nonpublic data not on individuals only when the access is authorized or required by statute or federal law. (Minn. Stat. § 13.05, subd. 9) b. Data has the same classification in the hands of the agency receiving it as it has in the hands of the agency providing it, unless the classification is required to change to meet judicial or administrative requirements. (Minn. Stat. § 13.03, subd. 4) When practical and necessary, the Responsible Authority or designee shall indicate the classification of not public data that the Responsible Authority or designee provides to a requesting government agency. 5. Time for Response. The Responsible Authority or designee will respond to all requests for confidential data on individuals or protected nonpublic data not on individuals in a reasonably prompt manner. CAH50884 GA115-26 33 6. Denying Access. If the Responsible Authority or designee believes that the requesting person is not entitled by law to have access to the data, the request will be handled in the manner provided in Section 7.F. 7. Fees. Fees may be charged only as provided in Section 9, "fees for copies of Government Data". & IDR Form Required. An "Information Disclosure Request" form (see Section 8) must be completed for each request for confidential data not on individuals or protected not public data. IE. Data Requests Related to Litigation. 1. Litigation involving the City. Any request for data or subpoena that is related to a lawsuit involving the City must be referred to the Responsible Authority, regardless of whether the data requested is public or not public, The Responsible Authority will inform the city attorney of the request, and either the Responsible Authority or the city attorney will respond to the request. 2. Subpoenaed documents or testimony. Occasionally private parties subpoena City employees to produce records or to testify concerning City records, in lawsuits that do not involve the City. The rules that implement the Act require that, if a City employee is subpoenaed to produce documents containing private or confidential data on individuals or to testify concerning private or confidential data on individuals, the City must notify the court of the statutes, rules, or regulations that restrict disclosure of the information. (Minn. Rules, Pt. 1205.0100, subp. 5.) To ensure that the City complies with its duties, all subpoenas must be referred to the Responsible Authority, who may consult with the city attorney before responding to the request. IF. Denying Requests for Access to Data. � 1. When access may be denied. Access to government data may be denied when the data is classified by state statute, federal law or temporary classification as not accessible to the requestor. 2. Responsible Authority or designee to make determination. If an employee handling a request believes that data requested is not public and that the requesting person is not otherwise entitled by law to have access to the data, the employee will refer the request to the Responsible Authority or designee. The Responsible Authority or designee will determine whether the requesting person is entitled by law to have access to the data. In making that determination, the Responsible Authority or designee may consult with the city attorney as deemed appropriate and will consult with the city attorney when required by this policy. 3. Denying access. If the requesting person is not entitled by law to have access to the requested data, the Responsible Authority or designee shall inform the requesting person of the CAH50884 GA125-26 34 denial, either orally at the time of the request or in writing as soon after that as possible, citing the specific state or federal law upon which the denial is based. Upon request of any person denied access to data, the Responsible Authority or designee shall certify in writing that the request has been denied and cite the specific statutory section, temporary classification, or specific provision of federal law upon which the denial was based. (Minn. Stat. § 13.03, subd. 3) � G. Commissioner Opinions._ 1. Opinions provided by Commissioner. The Commissioner of Administration is authorized to issue non-binding opinions on questions relating to public access to government data, rights of subject of data or classification of data under Minnesota law. An agency statewide system, political subdivision or person who acts in conformity with a Commissioner opinion is not liable for compensatory or exemplary damages, or awards of attorneys' fees, or penalties in actions under Sections 13.08 and 13.09 of the Act. The cost of an opinion is $200. (Minn. Stat. § 13.072) 2. Responsible Authority to request. The Responsible Authority, with the prior approval of the city administrator and advice of the city attorney, may request an opinion from the Commissioner whenever it is in the City's interest to do so. 3. Opinions to be distributed. The Responsible Authority will keep himself/herself advised of all opinions issued by the Commissioner. The Responsible Authority will distribute to all department heads copies of opinions that are applicable to City data. Department heads and Authorized Employees will handle City data in accordance with Commissioner opinions except when directed otherwise by the Responsible Authority and City administrator. The Responsible Authority and City administrator may, after consulting with the city attorney, direct department heads and City employees to disregard a Commissioner opinion that appears to be in conflict. CAHS0884 GAIIS-26 35 IA. Information Disclosure Request - General. I The 2 -part "Information Disclosure Request" as illustrated in Exhibit G provides a record of the requester identification information, the government data requested, and the action taken by the Responsible Authority or designee and any financial transaction which occurs. IB. When Completed. The "Information Disclosure Request" should be completed for any one of the following: 1. For all requests by the data subject or other persons for government data classified as other than public. NOTE: In cases where private or nonpublic data is routinely shared with the data subject, the designee may, with the approval of the Responsible Authority, elect not to complete the "Information Disclosure Request" form for each request. Private or nonpublic data may not be released to the data subject over the telephone unless the authorized employee recognizes the voice of the requesting person as belonging to the data subject. 2. For all requests by other government agencies for which the data is not routinely shared or provided in the non -nal course of business. 3. For requests for public data on individuals, when a fee is assessed. NOTE: An individual who requests public data may not be required to provide his or her name, address or other identifying information (except when copies are to be mailed to the individual) -- only the transaction is recorded. 4. For requests for government data when access is denied and the requester asks for the "written certification of denial" required by Minnesota Statutes, Section 13.03, subdivision 3. IC. Guidelines for Use. I I . Designees shall instruct all Authorized Employees on the correct use of the form. The Responsible Authority will assist in instruction when requested. 2. The "Information Disclosure Request" is divided into 4 sections: CAR50884 GAIIS-26 36 a. Section A records requester identification information. The name, address and other identifying information cannot be required of an individual requesting public government data (except where copies are to be mailed). Personal identifying information may be required for requests of data classified as other than public. b. Section B records the action taken by the designee. This section is always completed by the Responsible Authority, designee or other authorized employee. The "Authorized Signature" (item 12) should be that of the Responsible Authority or the designee. C. Section C records, when applicable, information pertaining to fees to be charged and collected. See Section 9, "fees for copies of Government Data". Item 14 provides for the calculation of the "Flat Rate". The total amount due is entered, as applicable, in either items 16 or 17. The current "Flat Rate" Is contained in Exhibit H. When the Special Rate is used and is not covered by a Standard Fee Schedule (Section 9.13.), the "Copy Cost Calculation Form", (Exhibit 1) is completed and attached to the "Information Disclosure Request Form". The total charges from the calculation form are entered, as applicable, in items 16 or 17. When the charges are based on a Standard Fee Schedule a copy of the calculation form used to establish the "schedule" need not be attached to the "Information Disclosure Request Form" form unless specifically asked by the requester. d. Section D provides the requestor with information that may be necessary to complete the transaction especially when all or part of the transaction is by mail. CAH50884 GA115-26 37 61TOW, ONS9 1913 Pursuant to the Minnesota Government Data Practices Act and unless otherwise provided for by federal law, state statute or rule, fees for government data shall be determined by departments based on the costs of providing such service. Fees shall be reasonable and consistent. IA. Fees Not Perm=itted=. 1. No fee may be charged for inspecting data. (Minn. Stat. § 13.03, subd. 3; Minn. Rules, Pt. 1205,0400, subp. 5) 2. No fee may be charged for time spent separating public from not public data. (Minn. Stat. § 13.03, subd. 3) B. Permitted Fees. "I'll . .......... 1. Responsible Authority Duties. Exhibit H contains a schedule of fees established by the Responsible Authority, The Responsible Authority will review Exhibit H annually and revise the schedule of fees as necessary. An explanation of the types of fees permitted by the Act follows. 2. Copying charges. When a person requests copies of data, copy charges as set forth in Exhibit H will be assessed for making, certifying, compiling, or electronically transmitting the copies of the data. 3. Labor charges. When a person requests copies of data, and where the time required to search for and retrieve the requested data exceeds one half hour, labor charges as set forth in Exhibit H will be assessed for searching for and retrieving the data. 4. Mailing charges. When a person requests copies of data, and the copies are mailed, mailing charges set forth in Exhibit H will be assessed. 5. Charges for commercially valuable data. When a person requests copies of public government data that has commercial value and is a substantial and discrete portion of or an entire formula, pattern, compilation, program, device, method, technique, process, data base, or system developed with a significant expenditure of public funds by the City, the Responsible Authority may establish a reasonable fee to be charged for the data in addition to the costs of making, certifying, and compiling the copies. The fee charged must relate to the actual development costs of the information. Upon request of any person, the Responsible Authority will provide documentation to explain and justify the fee being charged. The Responsible CAR50884 GA115-26 38 Authority shall revise Exhibit H from time to time as necessary to reflect commercial charges that the Responsible Authority has determined under this paragraph. (Minn. Stat. § 13.03, subd. 3) IC. Fees May Be Waived. 1. When another government agency requires or requests copies of data, and the data is usually provided as part of the normal course of business, the Responsible Authority or designee may provide the requested data at no charge. 2. When records, documents, brochures, pamphlets, books, reports, publications or other data are produced or provided for free distribution to the public, a fee ordinarily will not be charged. A charge may be assessed if an individual request exceeds normal distribution. ID. Data Provided with aCharge. When access is authorized, data shall be provided at the applicable rate for all other requests, including: Requests made by the media, including representatives of newspaper, radio and television. 2. Requests made by other authorized government agencies or responsible authorities who require or request records, documents, publications or other data which are not usually provided or reproduced as part of the normal course of business. 3. Requests for records, documents, brochures, pamphlets, books, reports, publications or other data that are not normally provided or reproduced for distribution to, the public. 4. Requests for copies of public and private data on individuals and public data and nonpublic data not on individuals. IE. Collection of 1. Generally, fees must be collected before data may be released or mailed to the requesting person. The Responsible Authority may authorize release of data without advance payment only if, in the Responsible Authority's judgment, special circumstances warrant the release and the fiscal responsibility of the requesting person is sound. 2. When the estimated cost of providing the data is $50.00 or more, the Responsible Authority or designee shall collect at least 50% of the estimated costs prior to making, certifying and compiling the data. 3. When the estimated costs of providing the data is less than $50.00, the requested data may be prepared prior to collecting the fees and provided to the requestor upon payment of the fees. CAH50894 CA115-26 39 F. Record of Copies. I An Information Disclosure Request form must be completed when required by Section 8, "Information Disclosure Request Form." CAH50884 GA115-26 40 A. Access to a Minor's Data by Parents, Guardians, or an Individual Acting as a Parent or Guardian In the Absence of a Parent or Guardian. 1. A parent or guardian or, in the absence of a parent or guardian, an individual acting as a parent or guardian, shall have access to all public government data on a minor data subject. A parent, guardian or, in the absence of a parent or guardian, an individual acting as a parent or guardian shall have access to all private government data on a minor data subject unless otherwise specifically denied access by a state statute or federal law. (Minn. Stat. § 13.02, subd. 8; Minn. Rules, Pt. 1205.0500) 2. The Responsible Authority and designee shall presume that a parent has the authority to exercise rights of the minor inherent in the Act unless the Responsible Authority or designee has been provided with evidence that there is a state law or court order governing such matters as divorce, separation, or custody, Or a legally binding instrument which provides to the contrary. (Minn. Rules, Pt. 1205.0500, subp. 2.13.) IB. Notification to Minors. 1. Unless otherwise provided for by law (e.g., educational and medical data), the Responsible Authority or the designee shall provide minors from whom private or confidential data is collected with a notification that the minor individual has the right to request that parental access to the private data be denied. This notification should be in writing and may be contained in the Tennessen Warning. (Minn. Rules, Pt. 1205.0500, subp. 3) (See Section 4, "Tennessee Warning") 2. A minor data subject who desires that parental access be denied must submit to the Responsible Authority or designee a written request that the data be withheld. The written request must set forth the reasons for denying parental access and must be signed by the minor. (Minn. Rules, Pt, 1205.0500, subp. 3.A.) 3. Upon receipt of the written request, the Responsible Authority or the designee shall determine if honoring the request to deny parental access is in the best interest of the minor. In making the determination, the Responsible Authority or the designee shall be guided by the following considerations: a. whether the minor is of sufficient age and maturity to be able to explain the reasons for and to understand the consequences of the request to deny access; CAH50884 GA115-26 41 b. whether the personal situation of the minor is such that denying parental access may protect the minor from physical or emotional harm; C. whether there is ground for believing that the minor's reasons for precluding parental access are reasonably accurate; d. whether the data in question is of such a nature that disclosure of it to the parent could lead to physical or emotional harm to the minor data subject; and e. whether the data concerns medical, dental or other health services provided pursuant to Minnesota Statutes, sections 144.341 to 144.347. If so, the data may be released only if failure to inform the parent would seriously jeopardize the health of the minor. (Minn. Rules, Pt. 1205.0500, subp. 3.13.) 4. Without a request from a minor, the Responsible Authority may deny parental access to private data on a minor pursuant to the provisions of Minnesota Statutes, section 144.335 (Access to Health Records) or any other statute or federal law that allows or requires the Responsible Authority the authority to do so, if such state statute or federal law provides standards which limit the exercise of the discretion of the Responsible Authority. (Minn. Rules Pt. 1205.0500, subp. 5) CAH50884 GA115-26 42 CHALLENGING THE ACCURACY AND COMPLETENESS OF DATA IA. Right to Contest. I An individual subject of data may contest the accuracy and completeness of public and private data concerning him/herself. B. Procedure for Contesting Accuracy or Completeness. 1. Written Request Required. An individual who wishes to contest the accuracy and completeness of public or private data about himJherself must submit a written notice to the Responsible Authority. The written notice shall contain the following. a. The name, address and phone number of the appealing party (provisions may be made for an individual who wishes to remain anonymous). b. A description of the claimed inaccuracy or incompleteness of the data in question. C. A list of past recipients of the data, if any, that the appealing party wishes to have notified, if the data is found to be inaccurate or incomplete. 2. Decision. Within 30 days, the Responsible Authority must either correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data, including recipients named by the individual, or notify the individual that the Responsible Authority believes the data to be correct. (Minn. Stat. § 13.05, subd. 4) The Responsible Authority should provide the data subject with: a written statement which informs the data subject of his or her right to appeal; and a copy of Minnesota Rules, Part 1205.1600. 3. Right to Appeal. An adverse decision of the Responsible Authority regarding the accuracy and completeness of public or private data may be appealed to the Commissioner of Administration. A notice of appeal must be filed with the Commissioner within 180 days after the Responsible Authority's decision or within 60 days if the Responsible Authority provides a written statement which informs the data subject of his or her right to appeal. The procedures for this appeal are contained in Minnesota Rules, Part 1205.1600. (Minn. Rules, Pt. 1205.1600, subp. 2) 4. Correcting Data. When an individual successfully challenges the accuracy or completeness of data about him/herself, the Responsible Authority must complete, correct, or destroy the challenged data, without regard to the requirements of Minnesota Statutes, Section 138.17, The Responsible Authority may retain a copy of the Commissioner of Administration's CAN50884 GA115-26 43 order or, if no order was issued, a summary of the dispute between the parties that does not contain any particulars of the successfully challenged data. CAHS0884 GAIIS-26 44 IIII9i i i I i:lziiirl i Im A. Appointment of the Responsible Authority. As required by the Act, the City Council has appointed a Responsible Authority, who has full administrative authority to carry out the duties assigned by the Act and Minnesota Rules, Chapter 1205. (Minn. Stat. § 13.02, subd. 16; Minn. Rules, Pt. 1205.2000.)" A copy of the resolution appointing the Responsible Authority is found at Exhibit J. Minnesota Statutes, section 13.05 lists the duties of the Responsible Authority in administering the Act. Exhibit K contains a "Data Practices Act Compliance Checklist" outlining the duties and responsibilities of the Responsible Authority in administering the Act. IB. Assignment of Designees. Minnesota Statutes, section 13.03, subd. 2 provides that the Reponsible Authority may appoint one or more designees to assist in performing the duties required of the Responsible Authority under the Act. The Responsible Authority, with the advice and cooperation of the department head, shall assign in writing one or more designees. The designee is the person in charge of individual files or systems containing government data and who receives and complies with requests for government data. A list of designees is found at Exhibit L. The Responsible Authority shall update Exhibit L as necessary to assure that the list is at all times accurate. IC. Security Safeguards for Government Data. I 1. Access to Not Public Data by City Employees. Only those employees whose job responsibilities require them to have access will be allowed access to files and records that contain not public data. The department head, with the advice and consent of the Responsible Authority, must determine which positions require access to not public data and must inform and instruct all department employees regarding the records to which employees are and are not allowed access. 2. Intraoffice Communications. Employees shall exercise care not to discuss, disclose, or otherwise release the contents of not public data to City employees whose job responsibilities do not require access to the data. 3. Removal of Data Restricted. Data that is classified as not public must be kept and filed only in City offices, and employees may not keep or maintain files of not public data at their homes. Employees may take not public data outside of City offices for up to one day only when necessary for attending to City business and only with prior approval of the appropriate CAH50584 GA115-26 45 department head. Removal of any not public data for more than one day requires prior written approval by the appropriate department head and the Responsible Authority. All department heads shall maintain a sign -out sheet for City files, which must contain the file identifying information, the date(s) the file was checked out and returned, the purpose for which the file was removed from City offices, the name of the employee who checked out the file, and the signed initials of the employee who checked out the file. No employee may remove public or not public data from City offices, where the data is the original, official, or only record maintained by the City, except as authorized by the appropriate department head and the Responsible Authority. 4. Security Safeguards. All employees whose job responsibilities require them to have access to private or confidential data on individuals shall adhere to the following security safeguards: a. Desks and file cabinets that contain private or confidential data must be locked during hours when the department is closed. b. Employees shall not leave private or confidential data in view in areas where the general public or non -authorized employees have ready access. C. Employees must shred private or confidential data before placing into trash cans or into recycling bins. d. Paper containing private or confidential data may not be used as "scratch" paper. e. Employees must not disclose their computer access codes to any other employee. It is preferable that employees memorize their computer access codes. However, if an employee determines it is necessary to keep a written reminder of the employee's access code, the employee should keep the code in a secure location, such as a locked desk drawer. f. Floppy discs and other magnetic/film media which contain private or confidential data shall be stored in a secured area when not in use. 9. To the greatest extent practicable, files that contain private or confidential data should be clearly labelled to that effect. h. A record must be made of every request for private or confidential data on individuals. (See Section 8, "Information Disclosure Request Form") 5. Contractor Access to Data. When a contract between the City and any person or entity requires that data on individuals be made available to the contracting party(ies) by the City, that data must be administered consistent with the Act. The contracting party must maintain the data on individuals which it received according to the statutory provisions applicable to the data. (Minn. Stat. § 13.05, subd. 6) To ensure that the contracting party complies with the Act, every party who contracts with the City (where contract performance requires that the party have access to data on individuals) shall execute an agreement in which the contracting party agrees to comply with the Act and to indemnify the City against any claim caused by the contracting CAH50984 GA115-26 46 party's failure to do so. Example agreements are shown at Exhibit M. The Responsible Authority shall maintain a file of all such agreements. This provision applies to all contracting parties whose contracts require access to data on individuals including, without limitation, insurance companies and claims adjusters, city attorney, prosecuting attorney, and labor consultants. 6. Training. The Responsible Authority shall provide or arrange for every new City employee to receive instruction regarding the basic requirements of the Act and of this policy. The Responsible Authority shall conduct or arrange for at least one training session per year for all designees, to review the requirements of the Act and to inform designees of recent changes in the Act. The Responsible Authority shall promptly inform designees of all legislative enactments that change a data classification or change procedural requirements under the Act. CM50884 GA115-26 47 IA. Reporting Requirements. 1. Creation of Public Document. The Act requires that the Responsible Authority prepare a public document containing the authority's name, title and address, and a description of each category of record, file, or process relating to private or confidential data on individuals that is maintained by the City. The public document must also include: the name, title and address of designees appointed by the Responsible Authority; identification of the files or systems for which each designee is responsible; and a citation of the state statute or federal law which classifies each type of data as private or confidential. All forms used to collect private and confidential data must be included in the public document. The public document must be updated annually by August 1. (Minn. Stat. § 13.05, subd. 1; Minn. Rules, Pt. 1205.1200, subp. 3) 2, Inventory of Data. The state rules that implement the Act require that the Responsible Authority prepare a list or index to all data or types of data currently collected, stored, used, or disseminated by the entity. The list or index must identify the state statute, federal law, or local ordinance that authorizes the programs or functions for which the data is collected, or which authorizes the actual collection, storage, use, or dissemination of data or types of data. The list or index is a public document, and it must be updated whenever a new statute, law, or ordinance or an amendment to an existing statute, law, or ordinance, authorizes new or different collection, storage, use or dissemination. (Minn. Rules, Pt. 1205.1500, subp. 3) For each type of record, file, or process that involves private or confidential data, the list or index must also identify: (a) the uses of and purposes for the collection of the data and (b) all persons, agencies, or entities authorized by state or federal law to receive any data disseminated from the particular record, file or process. (Minn. Rules, Pt. 1205.1300, subp. 4) 3. Identification of Data Collected Prior to August 1, 1975. The state rules that implement the Act require that the Responsible Authority determine, for each record, file or process that involves private or confidential data on individuals, whether the data contained therein was collectedrior to, on, or subsequent to August 1, 1975. Private or confidential data p I on individuals that was collected prior to August 1, 1975, may not be used, stored, or disseminated for any purpose, except the purposes listed in the public document prepared by the Responsible Authority. (Minn. Rules, Pt. 1205.1300, subps. I and 2; Minn. Stat. § 13.05, subd. 4(a). LB, Data Practices Annual Re 1, Report Form. The City has prepared a "Data Practices Annual Report" form that is a consolidation of the public document required by Section 13.05 of the Act and the data inventory CARS0884 GAII5-26 48 required by the implementing rules. Exhibit N is a sample page from the Data Practices Annual Report. A copy of the Data Practices Annual Report is located in each department. 2. Forms to be included with report. All form(s) used to collect private or confidential data on individuals are included in the Data Practices Annual Report. 3. Annual Updates. The Data Practices Annual Report must be updated on an annual basis to account for changes in types of data collected, data classifications, names of designees, or new or revised forms used to collect private or confidential data on individuals. IC. Data Practices Review Requirements. —1 1. Plan for data review and analysis. The Act and the Rules require that the City establish a plan to review and analyze the data administration practices of the City. (Minn. Stat. § 13.05, subd. 5; Minn. Rules, Pt. 1205.1500) Pursuant to the City's plan, the Responsible Authority has established mechanisms and procedures, more fully described in the paragraphs below, to ensure that data collected on individuals is accurate, complete, current and necessary. As used in this policy, these terms have the following meanings: a. "Accurate" means that the data in question is reasonably correct and free from error. (Minn. Rules, Pt. 1205.1500, subp. 2.A.) b. "Complete" means that the data in question reasonably reflects the history of an individual's transactions with the particular entity. Omissions in an individual's history that place the individual in a false light shall not be permitted. (Minn. Rules, Pt. 1205.1 SOU, subp. 2.B.) C. "Current" means that the data in question must be logically related to the entity's required and actual use of the data in its day to day operations. (Minn. Rules, Pt. 1205.1500, subp. 2.C.) d, "Necessary" means that: (i) the particular data is both required to carry out programs and functions that are expressly or impliedly authorized by a provision of state statute, federal law, or a local ordinance, and periodically examined, updated, modified, or referred to by the City; or (ii) the City would be unable to fulfill its duties without undue or increased burden or expense, if the particular data were not collected, stored, used, or disseminated; or (iii) retention of the particular data is required in the event that a legal action is brought against or by the City; or (iv) retention of the particular data is essential to, comply with a state or federal requirement that data be retained for a specified period for the purposes of auditing, records retention, historical interest, and other similar purposes. (Minn. Rules, Pt. 1205.1 SOU, subp. 4.) 2. Procedures to be followed. To ensure that data collected on individuals is accurate, complete, current, and necessary, all employees who collect, use, or disseminate data on individuals must adhere to the following procedures: CAH50884 GAA IS -26 49 a. At the time that data is collected from the individual data subject, the individual should be advised of his or her right to review and contest the accuracy or completeness of public or private data concerning him/berself. (See Section 4, "Rights of Subjects of Data - The Tennessen Warning" and Section 11, "Challenging the Accuracy and Completeness of Data.") b. An individual data subject should be encouraged to review his/her file for accuracy, completeness and currency. C. Whenever possible and practical, collect data about an individual from the individual subject of the data rather than from third parties (e.g., birthdate, address, etc.). (This directive does not prohibit employees from collecting data from third parties.) d. Design forms to collect objective types of data elements whenever possible, rather than data which calls for an opinion or conclusion or other subjective entry. Forms for the collection of data on individuals should request only necessary data. e. Department heads should periodically review forms used to collect data on individuals. Data elements that are not necessary or that lend themselves to ambiguity or subjectivity should be removed and the forms redesigned. Department heads should periodically conduct quality/validity checks on sample case files that contain data on individuals. 9. Each department head shall provide instruction and training to new employees regarding: (i) what records the employee will be required to maintain that include data on individuals; (ii) how to accurately record information provided by an individual; and (iii) the procedures for correcting inaccurate data (see Section 11, "Challenging the Accuracy and Completeness of Data"). If an employee discovers an inaccuracy in any individual data subject's record, the employee shall correct the inaccuracy by including in the data subject's record a writing that identifies the inaccuracy and the correct information and explains the basis for the change to the record. h. All records shall be disposed of according to the Records Retention Schedule adopted by the City. All forms used to collect private or confidential data must be reviewed by the Responsible Authority and attached to the Data Practices Annual Report. The "Forms Analysis Worksheet" as illustrated in Exhibit 0 may be used for the analysis and review of new and revised forms. CAH50884 GA115-26 50 SECTION 14 IA. Federal Law Requirements. 1, Use is restricted. Under federal law, the City may not compel the disclosure of an individual's social security number or deny any individual any right, benefit, or privilege provided by law because of the individual's refusal to disclose his social security number, EXCEPT that disclosure may be compelled and benefits may be denied for refusal to disclose if: a. disclosure of the social security number is required by federal statute; or b. disclosure is required by a statute or regulation adopted prior to January 1, 1975, for the purpose of verifying the identity of an individual, in connection with a system of records operated by a federal, state or local agency prior to January 1, 1975. (P. L. 93-579, 7, 88 Stat. 1909) 2. When disclosure may be compelled. Federal law permits any State or political subdivision of a state to require disclosure of an individual's social security number and to use an individual's social security number for the purpose of establishing the identity of the individual, in the administration of a tax, general public assistance, driver's license, or motor vehicle registration law within its jurisdiction. (42 U.S.C. § 405 (c)(2)(C),) For example, the State of Minnesota requires that homestead applications must include property owners' social security numbers. (Minn. Stat, § 273.124, subd. 13.) 3. Advisory required. A federal, state, or local government agency that requests an individual to disclose his social security number must inform the individual whether the disclosure is mandatory or voluntary, by what statutory or other authority such number is solicited, and what uses will be made of it. (P. L. 93-579, § 7, 88 Stat. 1909.) 4. Penalty for violation. A person who discloses, uses, or compels the disclosure of the social security number of any person in violation of the laws of the United States is guilty of a felony and subject to fine or imprisonment for up to five years, or both. B. State Restrictions. Federal law does not prevent cities from requesting voluntary disclosure of an individual's social security number when disclosure cannot be compelled, provided that the individual is informed that the disclosure is voluntary. State law, however, restricts the collection of data on individuals to that which is necessary for the administration and management of programs specifically CAH50884 GA115-26 51 authorized by the legislature or local governing body or mandated by the federal government. (Minn. Stat. § 13.0,5, subd. 3.) C. Directions for Use of Social Security Number. 1. City policy on use of social security number. Social security numbers may be requested from individuals only when collection or use of the social security number is mandated by federal or state law or when use of the social security number for purposes of identifying an individual is essential to the performance or operation of City functions that are required by federal or state law. 2. Designing forms. All forms used for the collection of data on individuals and existing as of the adoption of this policy have been reviewed for compliance with City policy regarding the use of social security numbers. All forms designed after the date of adoption of this policy, for the purpose of collecting data on individuals, must conform to the City policy on the use of social security numbers. The Responsible Authority is required to review and approve all forms used to collect private or confidential data on individuals. CMS08 B4 GAITS -26 52 Act means the Minnesota Government Data Practices Act, Minnesota Statutes Chapter 13, as amended. Authorized programs are those plans or procedures established by federal law, state statute or local governing body. City means the City of Elk River, Minnesota. Confidential Data on Individuals. Pursuant to Minn. Stat. § 13.02, subd. 3, confidential data on individuals means data which is made not public by statute or federal law applicable to the data and is inaccessible to the individual subject of the data. "Confidential" as used in some Minnesota Statutes and federal laws may actually mean "private data on individuals" as defined in Minn. Stat. § 13.02, subd. 12, if the data is accessible to the data subject. (Minn. Stat. § 13.02, subd. 3; Minn. Rules, Pt. 1205.0,200, subp. 3) Court Order means the direction of a court or judge made or entered in writing, and not included in a judgment. Data not on Individuals means all government data which is not data on individuals. (Minn. Stat. § 13.02, subd. 4) Data on Individuals means all government data in which any individual is or can be identitied as the subject of the data, unless the appearance of the name or other identifying data can be clearly demonstrated to be only incidental to the data and the data are not accessed by the name or other identifying data of any individual. (Minn. Stat. § 13.02, subd. 5) Data Practices Annual Report is a consolidation of some of the written reporting requirements of the Act including: (1) the Annual Inventory of Records, (2) the list or index to all data or types of data, and (3) the identification of the active and inactive records collected prior to after Aug. 1, 1975. Data Subject means the individual or person about whom the data is created or collected. Designee means any person designated by a Responsible Authority (a) to be in charge of individual files or systems containing government data and (b) to receive and comply with requests for government data. (Minn. Stat. § 13.02, subd. 6) Enabling Authority means the state, federal or local law that authorizes the program or function for which the data is collected, or which authorizes the actual data collection, storage, use or dissemination. Entity means any governmental agency subject to the requirements of the Act including state agencies, political subdivisions and statewide systems. CAH50884 GA115-26 53 Federal Law means the United States Code, rules of federal agencies as published in the Federal Register, and federal case law, including decisions of any court in the federal judicial system. Government Data means all data collected, created, received, maintained or disseminated by any state agency, political subdivision, or statewide system regardless of its physical form, storage media, or conditions of use. (Minn. Stat. § 13.02, subd. 7) Individual means a natural person (as opposed to a corporate person) for data on individuals. In the case of a minor or an individual adjudged mentally incompetent, "individual" may include a parent or guardian or an individual acting as a parent or guardian in the absence of a parent or guardian. (Minn. Stat. § 13.02, subd. 8) Information Disclosure Request Form records (a) requestor identification data, (b) a description of the information requested, (c) the action taken by the Responsible Authority, designee or his representative, and (d) any financial transaction which may occur. Informed Consent means (1) the data subject possesses and exercises sufficient mental capacity to make decisions which reflect an appreciation of the consequences of allowing the entity to initiate a new purpose or use of the data in question, and (2) forms which are used to record the authorization for a new purpose or use of the data in question. Exhibit F is an example of a form used to obtain and record the informed consent. Non -Disclosure Agreement is a signed agreement between a summary data requestor and the entity maintaining the requested government data on individuals whereby the requestor agrees to comply with the requirements of the Act in handling private and confidential data on individuals. (Minn. Rules, Pt. 1205.0700) Exhibit P is an example of a non -disclosure agreement. Nonpublic Data means data not on individuals which is made by statute or federal law applicable to the data: (a) not accessible to the public; and (b) accessible to the subject, if any, of the data. (Minn. Stat. § 13.02, subd. 9) Not Public Data means any government data which is classified by statute, federal law, or temporary classification as confidential, private, nonpublic, or protected nonpublic. (Minn. Stat. § 13.02, subd. 8a) Person means any individual, partnership, corporation, association, business trust or a legal representative of an organization. (Minn. Stat. § 13.02, subd. 10) Private Data on individuals means data which is made by statute or federal law applicable to the data: (a) not public; and (b) accessible to the individual subject of the data. (Minn. Stat. § 13.02, subd. 12) Protected Nonpublic Data means data not on individuals which is made by statute or federal law applicable to the data: (a) not public and (b) not accessible to the subject of the data. (Minn. Stat. § 13.02, subd. 13) Public Data Not on Individuals means data not on individuals which is accessible to the public, according to the procedures described in Minn. Stat. § 13.03. (Minn. Stat. § 13.02, subd. 14) CM5 08 8 4 GA115- 26 54 Public Data on Individuals means data on individuals which is accessible to the public, according to the procedures described in Minn. Stat. § 13.03. (Minn. Stat. § 13.02, subd. 15) Representative of the Decedent is (1) the personal representative of the estate during the period of administration; (2) the surviving spouse if there is not personal representative of the estate or after discharge of the personal representative; (3) any child; or (4) the father and mother. Requestor means the individual, entity or person requesting access and copies of government data. Responsible Authority: The Responsible Authority is the public officer who is required by the Act to administer the collection, storage, use and dissemination of government data for the particular governmental entity and to establish procedures and policies to ensure that the entity complies with the Act. The Responsible Authority for the City is designated by the city council. Rules, as used here means Minnesota Rules, Chapter 1205. State Agency means the state, the University of Minnesota, and any office, officer, department, division, bureau, board, commission, authority, district or agency of the state. (Minn. Stat. § 13.02, subd. 17) State Law means Minnesota Statutes, and decisions of any court in the state judicial system. State law includes rules promulgated, pursuant to statute, by a state agency, State Statute means acts and session laws enacted by the legislature and codified in Minnesota Statutes. Statute does not include special laws. Statewide System includes any record-keeping system in which government data is collected, stored, disseminated and used by means of a system common to one or more state agencies or more than one of its political subdivisions or any combination of state agencies and political subdivisions. (Minn. Stat. § 13.02, subd. 18) Summary Data means statistical records and reports derived from data on individuals but in which individuals are not identified and from which neither their identities nor any other characteristic that could uniquely identify an individual is ascertainable. (Minn. Stat. § 13.02, subd. 19) Temporary Classification means an application by a state agency, statewide system or political subdivision, pursuant to Minn. Stat. § 13.06, which has been approved by the Commissioner of Administration and not disapproved by the Minnesota Attorney General, and which temporarily changes the classification of government data, pending review by the Minnesota Legislature. Data that has not been expressly classified as public or not public by statute or federal law may be temporarily classified as private or confidential on data on individuals or nonpublic or protected nonpublic data not on individuals. Tennessen Warning is an advisory communicated to an individual who is asked to supply private or confidential data concerning himself/herself. The Tennessen Warning enumerates the CAJ45 0 8 8 4 GA115-26 55 individual's rights concerning the data, as enumerated in Minn. Stat. § 13.04, subd. 2. Exhibit E is an example of a Tennessen Warning. CAH50884 GA115-26 56 NOTE. If you collect private or confidential data add this information to your Tennessen Warning. Several State and Federal Laws better protect your privacy rights with regard to the information we collect, use and disseminate about you. These rights are described below. The information that we collect about you is classified as: Public - anyone can see the information Private - only you can see the information Confidential - you cannot see the information You have the right to be informed, upon request, whether you are a subject of government data and the classification of that data. (M.S. 13.04, Subd. 3) You have the right to be shown any public and private information we have on you at no charge. (M.S. 13.04, Subd. 3) You have the right to have copies of any public and private information we have on you but you may be charged a reasonable fee. (M.S. 13.04, Subd. 3) We will provide copies of the requested data about you immediately, if possible, or within five working days. If we cannot provide the data in five working days, we will notify you of this and we will provide the data within another working five days. You have the right to contest the accuracy and completeness of any public and private data we have on you, (M.S. 13.04, Subd. 4) You have the right to appeal any decision we made about your records. (M.S. 13.04, Subd. 4) To exercise any of these rights, contact: Patrick Klaers City of Elk River 13065 Orono Parkway P. 0. Box 490 Elk River, NIN 55330-0490 612-441-7420 CAH50864 GA115-26 I WA -11-1 0 1.140 a x WK aw IN An, The information requested in this application is based on the requirements of Minnesota Statutes Section 13.06, subdivision 2. Complete this application by providing all the information requested. Where this application does not provide enough space to answer a question, please complete your answer on a separate sheet, identify it by question number, and attach the sheet(s) to this application. Submit the completed application to: Commissioner, Department of Administration, 200 Administration Building, 50 Sherburne Avenue, St. Paul, Minnesota 55155. It is strongly recommended that you prepare this application in consultation with your legal advisor. Preparation of responses to certain questions, such as those concerning "compelling need," requires knowledge of legal standards for which legal guidance is indicated. The Public Information Policy Analysis Division of the Department of Administration will conduct a preliminary review of your application to make sure it is complete and in compliance with statutory requirements. The purpose of this review is to ensure the application makes a sound argument in support of a temporary classification so that it is not disapproved by the Commissioner because of technical or procedural problems. If any problems come to light during the review, you will be advised how to bring the application into compliance with statutory requirements. You may be asked to submit additional information in support of the application, or the application may be returned to you for revision. When your application is complete and meets all statutory requirements, it will be reviewed by the Commissioner. Pursuant to Minnesota Statutes Section 13.06, subdivision 1, if you file a new application, the data for which a private or confidential classification has been requested will receive the requested classification for a period of 45 days, or until the Commissioner approves or disapproves the application (whichever is earlier). In the case of an amended application, the time period is 20 days. Pursuant to Minnesota Statutes Section 13.06, subdivision 4, the Commissioner may consider a new application for statewide applicability. Should the Commissioner deem this approach advisable, the data for which the classification is requested will receive the requested classification for a period of 90 days, or until the Commissioner approves or disapproves the application (whichever is earlier). In the case of an amended application, the time period is 20 days. THE APPLICATION YOU SUBMIT IS A PUBLIC RECORD. A copy will be sent to members of the media community and to others who have requested receipt of copies. The Commissioner provides a period of 30 days from the filing of the application for the public to comment, and all comments are considered by the Commissioner in approving or disapproving the application. For further information, contact the Public Information Policy Analysis Division at (612) 296-6733 or 1-800-657-3721. M.0914 This application is: NEW AMENDED 1. This is an application for temporary classification of data on individuals as: PRIVATE CONFIDENTIAL pursuant to Minnesota Statutes Section 13.06, subdivision 2. (Only one box may be checked. An agency cannot apply for both types of classification on the same form. Separate applications must be prepared when requesting both private and confidential temporary classifications.) 2. Name and address of requesting agency: 3. This application is for: (Check one) this agency only. all similar agencies. (If applying on behalf of other agencies, you must provide a list identifying all such agencies. Indicate clearly that the agencies listed have agreed to participate in the application and that they agree to be bound by the ruling.) 4. Name and title of Responsible Authority making the application: Minnesota Statutes Section 13.06, subdivision. 1, states that only the Responsible Authority for an agency or subdivision, as defined in Minnesota Statutes Section 13.02, subdivision 16, can submit this application. Describe all data or types of data to be covered by this classification. This description must be as explicit and detailed as possible. Although item -by -item listings of data elements are not required, general terms such as "all personnel records ,,• "all police records," etc., are not acceptable. Where possible, specific file or record titles may be used. You may submit copies of the forms on which the data are collected. As part of your description you may exempt specific items that are public information. N 1W.4111114, 9. In order to establish, pursuant to Minnesota Statutes Section 13.06, subdivision 2 (b), "that a compelling need exists for immediate temporary classification," describe how release of the data "could adversely affect the public interest or the health, safety, well-being or reputation of the data subject." To establish a compelling need for a classification of data as private, you must detail the adverse effects of releasing the data to the public. To establish a compelling need for classifying the data as conjidential, you must describe the adverse effects if the data were released not only to the public but to the data subject as well. Consult with your legal advisor about the meaning of the term, "compelling need." It is not sufficient merely to affirm that a compelling need exists. You are required to state explicitly the nature of the compelling need and to cite facts supporting your assertions. Be as speciJI-c as possible in identifying adverse effects, sequences of events or cause -and -effect relationships. If relevant, cite any past instances where release of this kind of data to the public has adversely affected the public interest or the health, safety, well-being or reputation of the data subject. I affirm that all of the above statements are true to the best of my knowledge. I am aware that any classification made under this application expires June I of the year following its submission to the Legislature pursuant to Minnesota Statutes Section 13.06, subdivision 7, unless the Legislature takes action on the classification. Date Signature of Responsible Authority MS -00026-09 Rev, 5-96 4 R iR 6. Is there a Minnesota statute or federal law which currently allows classification of these data as private or confidential? YES NO If you are mile to specifically cite such a statute or federal law, there is ,no need to submit this application. The data you desire to classify are already classified by law. 7. Do you know of any statute or federal law which could be interpreted to forbid classification of these data as private or confidential? YES NO If yes, please identify. IN ORDER TO COMPLY WITH MINNESOTA STATUTES SECTION 13.06, SUBDIVISION 2, YOU MUST ANSWER EITHER QUESTION 8 OR QUESTION 9. PLEASEANSWER ONLYONE QUESTION. IF YOU ANSWER MORE THAN ONE QUESTION, YOUR APPLICATION WILL BE RETURNED. 8. Applicants must clearly establish that "data similar to that for which the temporary classification is sought has been treated as either private or confidential" (a) "by other state agencies or political subdivisions and" (b) "by the public." a) Please describe how similar data have been treated by other agencies, including statutory citations, examples and agency identifications where possible. b) Have any of the data covered by this application ever been made available to the general public, including the media, in the past? YES NO If yes, explain: APPLICATION FOR TEMPORARY CLASSIFICATION OF DATA NOT ON INDIVIDUALS AS NONPUBLIC OR PROTECTED NONPUBLIC The information requested in this application is based on the requirements of Minnesota Statutes Section 13.06, subdivision 3. Complete this application by providing all the information requested. Where this application does not provide enough space to answer a question, please complete your answer on a separate sheet, identify it by question number, and attach the sheet(s) to this application. Submit the completed application to: Commissioner, Department of Administration, 200 Administration Building, 50 Sherburne Avenue, St. Paul, Minnesota 55155. It is strongly recommended that you prepare this application in consultation with your legal advisor. Preparation of responses to certain questions, such as those concerning "compelling need," requires knowledge of legal standards for which legal guidance is indicated. The Public Information Policy Analysis Division of the Department of Administration will conduct a preliminary review of your application to make sure it is complete and in compliance with statutory requirements. The purpose of this review is to ensure the application makes a sound argument in support of a temporary classification so that it is not disapproved by the Commissioner because of technical or procedural problems. If any problems come to light during the review, you will be advised how to bring the application into compliance with statutory requirements. You may be asked to submit additional information in support of the application, or the application may be returned to you for revision. When your application is complete and meets all statutory requirements, it will be reviewed by the Commissioner.. Pursuant to Minnesota Statutes Section 13.06, subdivision 1, if you file a new application, the data for which a nonpublic or protected nonpublic classification has been requested will receive the requested classification for a period of 45 days, or until the Commissioner approves or disapproves the application (whichever is earlier). In the case of an amended application, the time period is 20 days. Pursuant to Minnesota Statutes Section 13.06, subdivision 4, the Commissioner may consider a new application for statewide applicability. Should the Commissioner deem this approach advisable, the data for which the classification is requested will receive the requested classification for a period of 90 days, or until the commissioner approves or disapproves the application (whichever is earlier). In the case of an amended application, the time period is 20 days. THE APPLICATION YOU SUBMIT IS A PUBLIC RECORD. A copy will be sent to members of the media community and to others who have requested receipt of copies. The Commissioner provides a period of 30 days from the filing of the application for the public to continent, and all comments are considered by the Commissioner in approving or disapproving the application. For further information, contact the Public Information Policy Analysis Division at (612) 296-6733 or 1-800-657-3721, This application is: NEW AMENDED 1. This is an application for ternorary classification of data not on individuals as: p NONPUBLIC PROTECTED NONPUBLIC pursuant to Minnesota Statutes Section 13.06, subdivision 3. (Only one box may be checked. An agency cannot apply for both types of classification on the same form. Separate applications must be prepared when requesting both nonpublic and protected nonpublic temporary classifications.) 2. - Name and address of requesting agency: 3. This application is for: (Check one) this agency only. all similar agencies. (If applying on behalf of other agencies, you must provide a list identifying all such agencies. Indicate clearly that the agencies listed have agreed to participate in the application and that they agree to be bound by the ruling.) 4. Name and title of Responsible Authority making the application: Minnesota Statutes Section 13.06, subdivision 1, states that only the Responsible Authority for an agency or subdivision, as defined in Minnesota Statutes Section 13.02, subdivision 16, can submit this application. 5. Describe all data or types of data to be covered by this classification. This description must be as explicit and detailed as possible. Although item -by -item listings of data elements are not required, general terms such as "all personnel records," "all police records," etc., are not acceptable. Where possible, specific file o ' r record titles may be used. You may submit copies of the forms on which the data are collected. As part of your description you may exempt specific items that are public information. �Q OWN$ 6. Is there a Minnesota statute or federal law which currently allows classification of these data as nonpublic or protected nonpublic? YES NO If you are able to specifically cite such a statute or federal law, there is no need to submit this application. The data you desire to classify are already classified by law. 7. Do you know of any statute or federal law which could be interpreted to forbid classification of these data as nonpublic or protected nonpublic? YES NO T1r 1i , ,:-=f " IN ORDER TO COMPLY WITH MINNESOTA STATUTES SECTION 13.06, SUBDIVISION 3, YOU MUST ANSWER QUESTION S, QUESTION 9, Q -R QUESTION 10. PLEASE AMSERONLY ONE QMTIOAr. IF YOU ANSWER MORE THAN ONE QUESTION, YOUR APPLICATION WILL BE RETURNED. 8. Applicants must clearly establish that "data similar to that for which the temporary classification is sought has been treated as either nonpublic or protected nonpublic" (a) "by other state agencies or political subdivisions and" (b) "by the public." a) Please describe how similar data have been treated by other agencies, including statutory citations, examples and agency identifications where possible. b) Have any of the data covered by this application ever been made available to the general public, including the media, in the past? If yes, explain: YES NO 3 PWA ON$ Ill. 9. Describe how "public access to the data would render unworkable a program authorized by law." (Minnesota Statutes Section 13,06, subdivision 3 (b).) Describe the program and cite the statute or federal law which authorizes it. It is not sufficient merely to affirm that public access to the data would render the program unworkable. You are required to describe the nature of the threat to the program and cite facts to support your assertions. Identify and describe specifically the adverse effects, sequences of events or cause -and -effect relationships that would make the program unworkable. If relevant, cite any past instances where release of this kind of data to the public has rendered a program unworkable. 10. In order to establish, pursuant to Minnesota Statutes Section 13.06, subdivision 3 (c), "that a compelling need exists for immediate temporary classification," describe how release of the data "could adversely affect the health, safety, or welfare of the public." To establish a compelling need for a classification of data as nonpublic, you must detail the adverse effects of releasing the data to the public. To establish a compelling need for classifying the data as protected nonpublic, you must describe the adverse effects if the data were released not only to the public but to the data subject as well. Consult with your legal advisor about the meaning of the term, "compelling need." It is not sufficient merely to affirm that a compelling need exists. You are required to state explicitly the nature of the compelling need and to cite facts supporting your assertions. Be as specific as possible in identifying adverse effects, sequences of events or cause -and -effect relationships. If relevant, cite any instances in the past where release of this kind of data to the public has adversely affected the health, safety, or welfare of the public. I affirm that all of the above statements are true to the best of my knowledge. I am aware that any classification made under this application expires June 1 of the year following its submission to the Legislature pursuant to Minnesota Statutes Section 13.06, subdivision 7, unless the Legislature takes action on the classification. Date MS -00066-06 Rev. 5-96 S Signature of Responsible Authority 004:1: 03#811 Minnesota Statutes, section 13.04, "Rights of Subjects of Data" requires that when an individual is asked to supply private or confidential data concerning himself or herself, he or she must be given certain information about why we need the data and how we will use it. In order to draft a "Tennessen Warning" which meets the requirements of Minnesota Statutes, sections 13.04, subdivision 2, 13.05, subdivision 8 and other provisions of the Data Practices Act, please complete the following: 1. Name of department and contact person. 2. Briefly describe the purpose and intended use of the information you are requesting. 3. Can the individual refuse to supply any of the requested information or is the information required? If the data is legally required, what is the authority (i.e., court order, statute, or federal law)? 4, What are the known consequences to the individual of supplying the requested data? (Examples: employment or program eligibility) 5. What are the known consequences to the individual of refusing to supply the requested data? (Examples. contempt of court, eligibility for employment or program participation) CA 50884 GA115-26 1 WIM: 11318C 6. List the identity of other individuals, entities or persons authorized by state or federal law to receive the data. (Examples: individuals whose work assignment request access, pursuant to court order, pursuant to state law), 7. Is any private or confidential data collected from a minor? If so, determine whether minor notification is required. CAH50884 GA 1s -z6 ramy,"n-Hym, As an employee of the City of Elk River ... . . and in accordance with the Minnesota Government Data Practices Act, the following information is provided regarding the information we collect about you. The personnel data we collect from you is used to record your employment history with the City, and in the administration of health insurance, pension plans, fringe benefits, workers' compensation, unemployment compensation and employee assistance programs. Your Social Security Number is required in the administration of taxes. You are not required to provide all of the information we ask you to provide; however, without certain information, we will not be able to process your application. If you have any questions about the information we ask you to provide, please contact the personnel office. The information we collect about you is classified as: 0 Public which means that the information is available to anyone who asks to see it; Private which means that the information is available only to the person the information is about, and to the staff who must use it in the normal course of conducting City business, and as otherwise provided for by law, and Confidential which means that information is not accessible to the data subject (e.g., certain human rights investigations). As an employee of the City of Elk River, the following information about you will be public: Name The final disposition of any disciplinary action together with the specific reasons for the action and Actual gross salary data documenting the basis of the action. a Salary range 0 The value and nature of employer -paid fringe benefits The basis for and the amount of any added remuneration, including expense reimbursement, in addition to salary (e.g., travel advance, tuition reimbursement and parking) a Your job title 0 Your job description 0 Education and training background 0 Previous work experience 0 Dates of your first and last employment with the City CAH50884 GA115-26 o The terms of any agreement settling administrative or judicial proceedings 0 Work location 0 Work telephone number 0 Badge number, if applicable 0 Your city and county of residence 0 Honors and awards received because of City employment Payroll time cars or other comparable data that record time worked for payroll purposes but not the reasons for the use of sick or other medical leave or other non-public data The status, but not the nature, of any complaints or charges against you, whether or not the complaint or charge resulted in a disciplinary action. Under the law, private personnel data may be shared with labor organizations to the extent that they need it in the conduct of normal business as your representative. Personnel data may be shared with personnel employees, accounting and payroll staff, insurance providers, City contractors whose contracts require access (e.g., the city attorney or insurance claims adjuster), the Public Employees Retirement Association (PERA), the Internal Revenue Service (IRS), Social Security Administration (SSA), State Department of Employment and Security, other states, as required by a court order, for the purposes of wage attachments, bankruptcies, and as may be required by any subsequent law. Information not listed as public, which is maintained as part of your personnel record, is private, and will not be shared with anyone but those members of our staff, appointing authorities, those whose work assignment requires access and, as authorized by law without your informed written consent. If you have any questions regarding your rights as a subject of data, please contact the Personnel Department. I have read and understand the above advisory. Date CAH50884 GA11S-26 Signature I; 1; 1 103 1 V 0 11 1, (name of individual authorizing release) authorize the (City of Elk River) (Economic Development Authority in and for the City of Elk River) (Housing and Redevelopment Authority of the City of Elk River) to disclose to the following information (description of information) for the following purpose: I understand that my records are protected under state and/or federal privacy laws and cannot be disclosed without my written consent unless otherwise provided for by state or federal law. I also understand that I may revoke this consent at any time and that in any event this consent expires automatically on 1 19. Executed this day of , 19 X (signature of individual authorizing release) I witnessed sign the above release; and s/he did so of his/her own free will. (signature of witness) CAH50884 GA115-26 CITY OF ELK RIVER INFORMATION DISCLOSURE REQUEST Minnesota Goverment Data Practices Act A. REQUESTER COMPLETE Note: Request Frequency - Private Data on individuals. After you have been shown the data and informed of its meaning, the data need not be disclosed to you six months thereafter unless a dispute or action is pending or additional data on you has been collected. You may be required to pay the actual costs of making, certifying and/or compiling the copies of information requested. 1. REQUESTER NAME (Last, First, MI) 2. DATE OF REQUEST 3. ADDRESS (it needed) 4. PHONE (if neoded) 5. DESCRIPTION OF THE INFORMATION REQUESTED 6,. REQUESTER SIGNATURE L 44 JWW AAc J"Ullc UUL UU ALUL IJIVYAJJc r.;UjLipicLc: uumajauun on numDers L ix,4 apevc, me aam may not De Me 10 De reteaSeC 10 You. P111111111 I I 7. DEPARTMENTIDIVISION NAME 8. REQUEST HANDLED BY 9. REQUEST TYPE 10. REQUESTED BY El In -Person ❑ mail El Phone ❑ Subject or Data D Not the Sukiect of Data 11. THE INFORMATION REQUESTED IS CLASSIFIED: 1) Public El Nom -Public El Private 0 Protected Non -Public ❑ Confidential 12. REQUEST 13, AUTHORIZED SIGNATURE n Approved D Denied 13 Approved in Part (Explain in#14) Today's Date 14. REMARKS/COMMENTS (If requested data is classified so as to deny access to the requester cite authority or reason. Also enter any other remarks or comments that arc appropriate.) C. DEPARTMENT/DIVISION COMPLETE WHEN FEES ARE ASSESSED (A receipted copy of this form is to be provided to the requester each time money is received) 15. El Fees: Flat Rate Fees Special Rate —(No. —of Pgs) X (Cost/Page) 16. El I have received from the above named, the amount indicated opposite my signature in payment for providing the information requested. D. REQUESTER PLEASE NOTE ITEMS CHECKED 1. 0 Make checkJmoney order payable to The City of Elk River 2. D If mailed, return entire form and any fees to: Received BY Today's Date 17. Total Amount Due S Received By Today's Date I 8a. Amount to be prepaid 5 (50% of est, totals over $50.00) Received By Today's Date 18b. Balance Due (Upon completion of copying) D. REQUESTER PLEASE NOTE ITEMS CHECKED 1. 0 Make checkJmoney order payable to The City of Elk River 2. D If mailed, return entire form and any fees to: EXHIBIT H (6/30/97) "I A "S a. Photoco-py rate (Flat Rate).. .............................. $ .15 per page b. Labor rate (research, assembly, computer services etc.)., ............ $20.00 per hour (15 minutes minimum) C. 'Postage ... ........................... I.... Prevailing rate d. Microfilm services From film to hard copy ................. $ 1.00 per page (includes labor cost) e. Copying (dubbing) audio tapes $ 5.00 per tape (Audio tape to be provided by requester) f. Copying (dubbing) video tapes .. $10.00 per tape (Video tape to be provided by requester) g. Meeting Packets ....................... $ 7.00 per packet *These rates are subject to change. The rates will be included in the fee schedule which is adopted by Council resolution, \\e1kriver\sys\shrdoc\ form sMUdiscr. doe EXHIBIT I CITY OF ELK RIVER COPY COST CALCULATION FORM FOR SPECIAL RATE INSTRUCTIONS: Use this SPECIAL RATE form when the cost of providing copies exceeds the FLAT RATE. REQUEST DATE REQUESTER NAME OF INFORMATION El The following calculations represent the ACTUAL COST of providing copies. EJ The following calculations represent the ESTIMATED COST of providing copies. (If the estimated cost of providing copies is $50. 00 or ore, the requester must pay at least 50% of the estimated cost before compiling, certifying and/or making copies.) SPECIAL RATE A. Labor: (NO. OF HRS.) (NO. OF HRS.) B. Photocopy: I (HOURLY RATE) X — (HOURLY RATE) X (PHOTOCOPY RATE) (NO. OF PAGES) C. Mailing: D. Publication Printing Cost: E. Other costs, describe: (To include computer time, programming time, terminal access, microfilming systems and any other costs not listed above.) 1. 2. 3, 4. ESTIMATED COST ACTUAL COST AMOUNT TO BE PREPAID TOTAL CHARGES $ AMOUNT TO BE PREPAID (50% of EST. TOTAL if $50 or over) $ AMOUNT DUE (Upon completion of copying) $ PREPARER NAME I DEPT/DIV I DATL 10MI11,14, RESOLUTION NO. RESOLUTION APPOINTING RESPONSIBLE AUTHORITY FOR PURPOSES OF THE MINNE- SOTA GOVERNMENT DATA PRACTICES ACT WHEREAS, Minnesota Statutes, section 13.02, subdivision 16, as amended, requires that the City of Elk River appoint one person as the Responsible Authority to administer the requirements for collection, storage, use and dissemination of data on individuals, within the City; and WHEREAS, the City of Elk River shares the concern expressed by the legislature on the responsible use of all City data and wishes to satisfy this concern by appointing an administrative- ly qualified Responsible Authority as required under the statute; and WHEREAS, the duties of Responsible Authority have in the past been performed by the city administrator; and WHEREAS, Patrick Klaers is the city administrator of the City. 1. The City Council of the City of Elk River appoints Patrick Klaers as Responsible Authority for the purposes of meeting all requirements of the Minnesota Government Data Practices Act, Minnesota Statutes, Chapter 13, as amended, and the rules lawfully promulgated by the Commissioner of Administration at Minnesota Rules, Chapter 1205. 2. Mr. Klaers is authorized to delegate the duties of the Responsible Authority to other City employees as Mr. Klaers, in his discretion, determines to be necessary in order to satisfy the requirements of the Minnesota Government Data Practices Act and at the same time continue to effectively and efficiently provide other City services. This resolution becomes effective immediately upon its passage. Adopted by the Elk River City Council on q_ '& a , 1997. ATTEST. - Sandra Thackeray, City Clerk Hank Duitsman, Mayor WIT W-MM119 CITY OF ELK RIVER MINNESOTA GOVERNMENT DATA PRACTICES COU.PLJ-4,NCE CVECYLIST Citations in the format M.S. 13.05 refer to "Minnesota Statutes, Section 13.05." Citations in the format of 2 MCAR 1.200 refer to the "Minnesota Code of Agency Rules." Citations in the format of 1205.0000 are contained in the "Minnesota Rules 1983" prepared, compiled and published by the Revisor of Statutes. These rules supersede the "Minnesota Code of Agency Rules" (2MCAR 1.201 - 1.218). Appoint a Responsible Authority (See Advisory Forms A -D in the appendix of the "Rules Governing Data Practices"). (2MCAR 1.210 or 1205.1000) El Responsible Authority may appoint "Designees". This appointment must be in writing and is a public document. (M.S. 13.02(6), M.S. 13.03 (2), 2MCAR 1.211 or 1205.1100) I Dem. 171MM 1 -1 — - Establish procedures to describe how access may be gained to public data. (M.S. 13.03, 2MCAR 1.203(A)(I) or 1205.0300(3)) Establish written procedures to assure that access to private data is gained by only authorized parties. (M.S. 13.05(5), 2MCAR 1.204(B) or 1205.0400(3)) F-1 Establish written procedures to assure that access to confidential data is gained by only authorized parties. (M.S. 13.05(5), 2MCAR 1.206(B) or 1205.0600(3)) El Establish procedures for access and preparation of public summary data. (M.S. 13.05(7), 2MCAR 1.207 or 1205.0700, 2MCAR 1.203(A)(1) or 1205.0300(3)) Establish procedures to assure that all data is accurate, complete and current for the purposes for which it was collected (M.S. 13.05(5), 2MCAR 1.214(10 or 1205.1500(2)) *Denotes elements which comprise the "Data Practices Annual Report" CAH50864 GA115-26 El Establish appropriate security safeguards for all records containing data on individuals. (M.S. 13.05(5), 2MCAR 1.204(b) or 1205.0400(3)) ❑ Educate personnel as to provisions of the Act which may pertain to them; prepare administrative procedures that will acquaint personnel with authorized purposes and use. (2MCAR 1.213(17) or 1205.1300(5)) ii 1 1111 11111 ON 11�11 1111 11.211 i ❑ Prepare public document describing the "Rights of Subjects of Data." (M.S. 13.05(8)) El *Prepare public document with the name, job title and business address of the Responsible Authority and the names and job titles of any appointed designees. This document must be made available to the public and/or posted in a conspicuous place. (M.S. 13.05(1), 2MCAR 1.212 or 1205.1200) ❑ *Prepare, by August I of each year, a public document which identifies and describes, by type, all records, files and processes which contain private and confidential data. (See Advisory Form E contained in the appendix of the "Rules" and the "Data Practices Annual Report". (M.S. 13.05(1), 2MCAR 1.212 or 1205.1200(3)) ❑ *Review and identify all active and inactive types of data (M.S. 13.05(4)(a), 2MCAR 1.208 or 1205.0800) ❑ *Determine what types of data are classified as private or confidential (2MCAR 1.208 or 1205.0800) El *Identify the state statute or federal law which classifies the data as private or confidential (2MCAR 1.208 or 1205.0800) For data collected prior to August 1, 1975: (M.S. 13.05(3), 2MCAR 1.213(A) or 1205.1300(2)) R *Review the enabling authority for the collection of private and confidential data. ❑ *Identify the purposes of the collection of the private and confidential data at the time the data was originally collected. 0 *Handle the data consistent with the purpose authorized at the time the data was originally collected. *Denotes elements which comprise the "Data Practices Annual Report" CAH50884 GA115-26 2 F". off-WI-JIMN For data collected on or after August 1, 1975: (2MCAR 1.213(8) or 1205.1300(3)) El *Review the enabling authority for the collection of the private or confidential data. El *Identify the purposes of and the intended uses of the private and confidential data. El *Prepare lists which identify the uses of and purposes for the collection of private or confidential data (M.S. 13.05, 2MCAR 1.213(C)(1) or 1205.13,00(4)) ❑ *Each list shall identify all persons, agencies or entities authorized by state or federal law to receive any private and confidential data disseminated from the record (This information is used to prepare or is available from the "Tennessen Warning"). (M.S. 13.05, 2MCAR 1.213(0)(1) or 1205.1300(4)) ❑ *Prepare a list or index to all data or types of data currently collected, stored used or disseminated by the entity. The list shall include the identification of statutes, federal laws, or local ordinances which authorize the programs or function for which data or types of data are collected, or which authorized the actual collection, storage, etc, of the data. (2MCAR 1.214 or 1205.1500) El Prepare a "Tennessen Warning" (Rights of Subjects of Data) for all private and confidential data collected from the data subject. (M.S. 13.04(2), 2MCAR 1.213(0) or 1205.1300(1)-(3)) El Prepare the "Notification to Minors" of their right to request that we deny parental access to their private data. (This may be incorporated into the "Tennessen Warning".) (M.S. 13.02(8), 2MCAR 1.205(0) or 1205.0500(3)(A)) *Denotes elements which comprise the "Data Practices Annual Report" CAH50684 GAIIS-26 3 F*NUT11-13VI", Formulate a plan that will provide for the review and analysis of the data administration practices of your office. (2MCAR 1.214 or 1205.1500) in -7 El Review all forms to ensure that the data collected are necessary, that data which are determined to be unnecessary are no longer collected and stored, and that unnecessary private and confidential data are no longer used and disseminated. (M.S. 13.05(3), 2MCAR 1.214(B) -(C) or 1205.1500(4)-(5) El Dispose of unnecessary government data pursuant to the Records Management Act. (M.S. 138.17, 138 and M.S. 15.17, 2MCAR 1.214(0)(2) or 1205.1500(5)(B)) *Denotes elements which comprise the "Data Practices Annual Report" CA1450884 GAIL'S -26 4 Responsible Authority Designees Address for Responsible Authority and Designees City of Elk River 13065 Orono Parkway P. O. Box 490 Elk River, MN 55330-0490 Telephone: 612-441-7420 CAH50884 GA115-26 Records Administration, except Personnel and insurance records Police Department Public Works Department Community Development Department Finance Department Recreation Department Fire Department Personnel and insurance records *Denotes elements which comprise the "Data Practices Annual Report" Sample: _Amendment to existing contract I THIS AGREEMENT is made , 199_, by and between the CITY OF ELK RIVER, a Minnesota municipal corporation ("City") and a ("'Contractor"). Recitals A. The City and Contractor have entered into a contract dated Contractor is required to MIT04=14mil B. In order to perform its obligations under the contract, Contractor requires access to the following data: . Some or all of the requested data is classified as not public under the Minnesota Government Data Practices Act, Minn. Stat. §§ 13.01 et sem. (the "Act") and is subject to restrictive provisions regarding its release or disclosure. C. The data requested by Contractor is reasonably necessary for the performance by Contractor of its obligations under the contract. D. Section 13.05 of the Act requires that, when a contract requires a governmental unit to make data on individuals available to a contracting party, the contracting party must maintain the data according to the provisions of the Act. E. The City and Contractor desire to clarify the responsibilities of the parties with respect to providing, maintaining, and disseminating data that is subject to the Act. Agreement In consideration of the mutual covenants made in this Agreement, the parties agree as follows: 1. City to Provide Data. The City agrees to provide to Contractor data, including data on individuals (Requested Data) as requested by Contractor under this Agreement. 2. Contractor Responsibilities. Contractor shall have the following responsibilities: a. Contractor will request access to only that data necessary for Contractor to perforin its obligations under the Contract. CAH50864 GA115-26 V ii lMA I b. Contractor and its employees will not release Requested Data or disclose the contents of Requested Data to any person, including Contractor employees, except as expressly authorized by this Agreement. C. Contractor may release Requested Data to those Contractor employees whose job responsibilities require them to have access to the data in performance of the contract. Contractor will inform its employees that the data is subject to the Act and this Agreement. d. Contractor may not release Requested Data to other persons except at the written direction of the City. Contractor will refer to the City any and all requests for release or inspection of Requested Data that Contractor may receive from persons not authorized by this Agreement to have access to Requested Data.. e. When Contractor no longer requires the Requested Data for the performance of the contract, Contractor will return to the City the Requested Data and all duplicates or copies of the Requested Data. If the Requested Data was electronically transmitted to Contractor, Contractor will destroy any hard copies made of the Requested Data, transfer the electronically transmitted data to a diskette which shall be returned to the City, and erase or delete the Requested Data from Contractor's diskettes or computer systems. 3. Indemnification. Contractor agrees to defend and indemnify City from any claim, liability, damage or loss asserted against City as a result of Contractor's failure to comply with the requirements of this Agreement.. 4. This Agreement is intended to amend the contract referenced above. Except as expressly modified in this Agreement, all other provisions of the Contract remain in full farce and effect. CONTRACTOR CITY OF ELK RIVER z *Denotes elements which comprise lite ".Data Practices Annual .Report" CAH50884 GAIIS-26 Sample: provision in new contracts Data practices coMgliance., Contractor shall have access to data collected or maintained by the City as necessary to perform Contractor's obligations under this contract. Contractor agrees to maintain all data obtained from the City consistent with the requirements of the Minnesota Government Data Practices Act, Minn. Stat. § § 13.02 et seq. (the "'Act"). Contractor will not release or disclose the contents of data classified as not public to any person except at the written direction of the City. Contractor agrees to defend and indemnify the City from any claim, liability, damage or loss asserted against City as a result of Contractor's failure to comply with the requirements of the Act or this contract. Upon termination of this contract, Contractor agrees to return data to the City, as requested by the City. *Denotes elements which comprise the "Data Practices Annual Report" CAH50884 GA115-26 W t 47 -C V) �- 0 u 0. a. ca. 0. 06 VD N1 PJY C c ca c 78 w c c G. c L.,o L. 0 •0 eia.,9-L. 0 u Cl L- c Ja c W c (p c 0 C D 3 (4 z w c c x 0 L- c 0 I- 0 (- c L- L.0 0 c 0 2 0 - 0 8: E4c. dr c] _j .2 , .2 C u C c C (A a c o w CL W - Lu w 4p 0 c w c Q) c v w.- c>o Qj w C> y I - 4) anups w co FL wW r- cz a o uj 1 4) aj Q 0 0 1- 4)i. "CCi •G 4) 0 cL 10 C. 06 Q. Q6 Q. -C r4 uj uj u 0 uj L) 0 c M w Lu ca aj .8 > Q Lc Lu Qj I- o a c u ca 0 lu Cc 3• .5 (n c 4- to 0 L. 4) 43 0 tjO6u to s CL D 0 L CD cc 0 E o3 0 ul cn (i > Ix c Lu c 13 -a Z &- �; uj I - = of uj a CJ ra 2 L) Jc; u = c t- v) "0 0 uj o 0 u) m -C c CJ cL < 0 ='F fn 0 o� ca m o w m I I r4 Q)— = — Lu = ca D Lu 0 cc (L ul 0. 'A LuIm to wj uj.c w w > oa 0 m - 0 uj 0 RP! (1) u w Q C cAWiL rA inCi W = 0 W- > > W > - w aj - LO ix En CA Id: OC -K <,C < < - -c � X.2 = _j U cc 0 uj - Lu M 0 - m 0 (L -K 3 u c w w a of W w w u. Lu C La v = C (L = Q w 0 cc,- -C COo :) o Q7 o o m CL 0 cz r Ci. CD 0 0 (D rIj cD wl o Ir 0 LA 0 lo c) co c� Ol o 0 �2 C'1 0 cD 0 a) o 0 o 0 C.7 u W. X: S. x 3c x x x x x ;c ;c uj !Z M Q Q< < o c - C>Q -Ic 0 < cl dK Mei -1613-0-11KC FORMS ANALYSIS WORKSHEET Form Title: Form No. I Cite the state statute, federal law or local ordinance which authorizes the program or the actual data collection, storage, use and dissemination. 2. State the purpose and intended use of the information collected on the form. 3. What is the classification of the data being collected? (Check one or more.) ❑ Public ❑ Private ❑ Confidential ❑ Nonpublic ❑ Protected Nonpublic 4. What is the state statute or federal law that classifies the data as other than public? 5. Where (physical location) will the information be collected? 6. How will the information be entered? ❑ Handwritten ❑ Typewriter ❑ Printer ❑ Other, explain 7. Who will collect/enter the information? 8. When will the information be collected? 9. Is the information being collected already available somewhere else? On another form? 10. What are the associated forms before and after completion? Does the form collect all the data needed by the associated forms? 11. What reports, summaries, forms, etc. will this form generate or cause to be completed? *Denotes elements which comprise the "Data Practices Annual Report" CAH50884 GA115-26 12. What business equipment will be used to process this form? (Describe type, make and model.) 13. How will the form be referenced? ❑' Name ❑ Case/file4 ❑ SSN# ❑ I.D.# ❑ Other, describe 14. Where will the information be filed/stored? 15. How will the form be filed? ❑ Std. 8 1/2 x 11 file ❑ Legal file ❑ Tape/Disc ❑ Other, describe 16. Will the data be keypunched? ❑ No ❑ Yes IT How many copies of the form will be needed (1, 2 or 3 -part form) and where does each part go? 18. How long must the information be kept? (Cite statute or law.) 19. How many forms will be used in: 6 months I year 20. Is the information/form on a Records Retention Schedule? ❑ No ❑ Yes 21. Prepare and attach a forms flow chart. Operation Transport Store Delay Inspect *Denotes elements which comprise the "Data Practices Annual Report" CAH50884 GA115-26 2 17%,#�@ 0 6, 9 22. Is there a "Tennessen Warning" currently being used that will cover this data? 23. What are the consequences of supplying or refusing to supply the requested information? 24. List all individuals, entities or persons authorized to access this information. 25. List data elements which are not legally required to be completed. Reviewer Name Department Date *Denotes elements which comprise the "Data Practices Annual Report" CM50884 GAMS -25 3 EXHIBIT P GOVERNMENT DATA ACCESS AND NONDISCLOSURE AGREEMENT NOTE: Review the following with your attorney 1. City of Elk River hereby authorizes - to the following described government data: the Requestor, access 2. Access to the above specified government data (or data subjects) shall be for the purpose of, 3. COST. The Requestor agrees to bear the costs associated with the preparation of the data which has been determined (estimated) to be $ pursuant to Attachment A. 4. ACCESS TO DATA SUBJECTS. (Optional) If access to data subjects is required for the purposes outlined in paragraph 2 above the data subject will be pre-screened by the City for the data subject's willingness to be contacted by the Requestor. This will be accomplished by a form letter mailed to the data subject by the City, at the Requestor's expense, explaining the study and its purposes. A consent form will be attached to the form letter to be signed by the data subject authorizing individual access and returned to the City. The consent form shall explain the purpose of the study; any consequences to the data subject and explain that the data subject may withdraw consent at any time. The Requestor shall offer to answer any inquiries by the data subjects and indicate where those inquiries may be directed. No disclaimer of responsibility by the Requestor may be used and the privacy rights of data subjects may not be waived. 5. SECURITY. The Requestor shall protect the privacy interests of individual data subjects and hereby agrees that all data classified by state or federal law as not public which is obtained from City records or through contacts with data subjects and incorporated into reports, summaries, compilations, articles, or any document or series of documents capable of publication shall have all unique personal identifiers removed which could be used to identify any individual(s) afforded confidentiality. Data contained in files, records, microfilm, computer discs or tapes, or other storage media maintained by the City are the property of the City and are not to leave the custody of the City. The Requestor agrees not to make reproductions of any data in the files or remove any such data from the research site that can in any way identify an individual in the exercise of this Agreement. *Denotes elements which comprise the "Data Practices Annual Report " CAH50884 GAIIS-26 [am-ev�v I The Requestor, or its employees and its agents involved in this project agree that no data obtained during the project that is irrelevant to the purpose of this project will ever be disclosed or communicated to anyone by any means. The Requestor warrants that the following named individual(s) shall be the only one(s) who shall participate in the collection of the aforementioned data during the course of the project: (Enter the names of individuals accessing/collecting data.) 6. NONDISCLOSURE. The Requestor is liable for any unlawful use or disclosure of government data collected, used and maintained in the exercise of this Agreement and classified as not public pursuant to Minnesota Statutes, Chapter 13 or any other state or federal law, and the Requestor understands that he/she may be subject to the civil or criminal penalty provisions of Minnesota Statutes, sections 13.08 and 13.09. The Requestor agrees to defend, indemnify and hold the City, its officers and employees harmless from any liability, claims, damages, costs, judgments or expenses, including reasonable attorneys' fees, resulting directly or indirectly from an act or omission (including without limitation professional errors or omissions) of the Requestor, its agents, employees or assignees resulting from Requestor's activities under this Agreement and against all loss by reason of the failure of said Requestor to fully perform in any respect all obligations under this Agreement. 7. INSURANCE. (Contact your attorney for the application of this section.) In order to protect himself/herself as well as the City under the indemnity provisions hereinabove set forth, the Requestor agrees at all times during the term of this Agreement to have and keep in force a single limit or combined limit or excess umbrella professional liability insurance policy covering the activities of the Requestor while performing under this Agreement in the following amounts: $1,000,000 per claimant for personal injuries and/or damages and $1,000,000 for total personal injuries and/or damages arising from one occurrence. Such policy shall, by specific endorsement, acknowledge the agreement between the Requestor and the City. 8. PROJECT ACCESS PERIOD, The project data or data subject access period shall be from to and in any event access authorization will be terminated on 9. SURVEY RESULTS. A copy of the reports, summaries, compilations, articles, publications or any document or series of documents capable of publication shall be made available to the City in its entirety. Signed: Date (Signature, Title, Organization and Address of Requestor) Signed: Date (Signature, Title and Address of City Representative) *Denotes elements which comprise the "Data Practices Annual Report" CAH50884 GA115-26 2 • Imo' I �i �► The Data Practices procedures are adopted to comply with the requirements of the Minnesota Data Practices Act. This document entitled "Data Practices Working Handbook" is to be used as a quick reference guide to obtain general information about data practices procedures. The City of Elk River has adopted the "City of Elk River Guidelines and Procedures for the Minnesota Government' Data Practices .Act." This document is considered to be the official data practices guidelines for the City of ]Elk River. IL ACCESS TO PUBLIC DATA PEOPLE ENTITLED 7wAccEem.................................................................................... ............. ................... 2 rv*uM OFREQUEST ......................... .................................. ............................................................ : ..---..-» TIME LIMIT .----_—'---~.~_,.__.~.-..,._~.,..~~,---_--_-,-,_'.,-,,.,'-.~._~.~3 IEEy_....... .,^.............................................................................................................................. ....... 3 PEmmgONeLDAoA .-_-.,,-_.-.,_---_-----__---.___----'_---_--.-._-.-_.-4 __-__-_-_---_-.................. ......... ^..................... ................... .......................................................... - PROPERTY COMPLAINT DATA ........................................................................................................................ 5 SECURITY INFORMATION ....................... ...... ......................................... .......... -.................... ....... ......... 5 SEALEDBIDS ... .................. ...... ,^_,..~.__^_........................................................................................ m LABOR RELATIONS INFORMATION ................................................................................................................ 6 FIREARMSDATA ....................................................................................... -....... ......... ........................... o EXAMINATIONDATA ............................................. ................... --- .................... _................................... 6 ELECTED OFFICIALS --._----_--_------....--...._.-.--------.0 CIVILINVESTIGATION DATA ........................................................................ ................... ............................. w APPRAISAL DATA .............. ......... --_-___.......... _........................................................................ 7 ASSESSORS DATA ............. ........................ ...................................................................................... ... _./ TRANSPORTATION SERVICE DATA ............................................ .......... ..... ._............ ...... ......................... .7 RECREATIONDATA ......... ....... ....................................................................... ........................................... LAW ENFORCEMENT DATA ............ ......................................................................................................... _.D CITY ATTORNEY RECORDS ..................... .......................... .................... -_----_-._-__............ ^..y LICEnSINmGDuTu......................................................................... ........................ ...... ...................... .~..v IV. DEFINITIONS OF DATA ON INDIVIDUALS PUBLIC DATA ONINDIVIDUALS ........................................................ .......................................... ............. ..9 PRIVATE DATA OmINDIVIDUALS ............. ..................... -....... ........... ....................................................... 9 VLCOST FOR SERVICES.....................................................~.~.-.-~..~~.~....~~..~~.~~.~~~11 VII. MEETING PACKET REQUEST FORM ..................................................................................... 12 The person who is the responsible authority for compliance with the Data Practices Act is the City Administrator. The responsible authority has designated certain other City employees to assist in complying with the Act. These designees are as follows: M�Lxaisal Data �; City Clerk '-Building Plans 7 city Attorney Records City Clerk 151 RN M Me Emplo ent Data City Clerk Firearms Data Police Chief Insurance Claims! Finance Director Labor Relations Data Police Chienance Director Police Chief Licensing Data a Cit Clerk - - -------- ----- ------ - ----- - ---------- Personnel Data i Finance Director Property Complaint Data ----------- Recreation Data Community Recreation Director ::Sealed Bids City Clerk Security Information Police Chief All information maintained by the City is public unless there is a specc statutory designation which gives it a different classification. A. People Entitled to Access. (Page 29 of City's Data Practices Policy) im Any person has the right to inspect and copy public data. The person also has the right to have an explanation of the meaning of the data. 'The person does not need to state his or her name or give the reason for the request. 9 B. Form otRequest. , (Page 30 of City's Data Practices Policy) Id The request for public data may be made by telephone, in writing or in person. In order to preserve efficient operation of City departments, each department head may establish limits on the number or types of requests to which the department will respond over the telephone. Written requests are preferred and may be required by the Responsible Authority or designee. C. Time Limit. (Page 30 of City's Data Practices Policy) %I Authorized City employees will respond to all requests for public data in a reasonably prompt manner. Whenever possible, the authorized City employees will immediately provide the requested information or allow the requesting person to inspect the public data. Where an immediate response would unreasonably interfere with the efficient performance of the City's operations, an authorized City employee may require that the requesting person make an appointment or return at a later time to inspect or to pick up copies of the: requested data. Any delay in providing requested data must be reasonable in relation to the quantity of data requested, the time needed to retrieve and collect the requested data. D. Fees. (Page 38 and Exhibit H of City's Data Practices Policy) % Fees may be charged only if the requesting person asks for a copy or electronic transmittal of the data. Fees will be charged according to the City's standard photocopying policy, unless significant time is required. In that case, the fee will include the actual cost of searching for, retrieving, and copying or electronically transmitting the data. The fee may not include time necessary to separate public from non-public data. 3. A. Personal Datai(Privat IEL Minn, Stat. 13.43 % All data about an individual who is employed as, or an applicant to be, an undercover law enforcement officer. All data on all other individuals who are or were an employee, an applicant for employment, volunteer, independent contractor, or member or applicant for advisory board or commission, except the following which is public: a Name -P Actual gross salary • Salary range • Contract fees • Actual gross pension • Value and nature of employer paid fringe benefits • Basis for and amount of added remuneration,, including expense reimbursement • Job title • Job description • Education and training background • Previous work experience • Date of first and last employment • The existence and status (but not nature) of any complaints or charges against the employee, whether or not resulting in discipline • Final disposition of'any disciplinary action, with specific reasons for the action and data documenting the basis of the action, excluding data that would identify confidential sources who are employees • Terms of any agreement settling any dispute arising from the employment relationship, including a "buyout" agreement • Work location • Work telephone number • Badge number • Honors and awards received because of City employment • Payroll time sheets or, other comparable data that are only used to account for employee's work time for payroll purposes, except to the extent that release of time sheet data would reveal the employee's reasons for the use of sick or other medical leave or other non-public data 0 City and count of'residence 9 id Names and home address of applicants for appointment to and members of an advisory board or commission B. Emp1gyment Data (Private). Minn. Stat. 13.43 SA Data about current and former applicants for employment or appointment to an advisory board or commission, except the following which is public: • Veteran status • Relevant test scores • Rank on eligible list • Job history • Education and training • Work availability • Name, after being certified as eligible for appointment to a vacancy or when considered a finalist for a position of public employment (which occurs when the person has been selected to be interviewed by the appointing authority) !6 Names and addresses of applicants for and members of an advisory board or commission are public. C. Property Complaint Data (Confidential) Minn. Stat. 13.44 I, The identities of individuals who register complaints, concerning violations of state laws or local ordinances concerning the use of real property. D. Security InLormation (Private). Minn. Stat. 13.3,7 $A Data which if disclosed would be likely to substantially jeopardize the security of information, possessions, individuals or property against theft, tampering, improper use, attempted escape, illegal disclosure, trespass, or physical injury. This includes crime prevention block maps and lists of volunteers who participate in community crime prevention programs and their home addresses and telephone numbers, but these may be disseminated to other volunteers participating in crime prevention programs. 5. . i a Minn. Stat 13.37 .% Sealed bids, including the number of bids received, prior F. Labor Relations Information (Private). Minn. Stat. 13.37 Ad Management positions on economic and non -economic items that have not been presented during the collective bargaining process or interest arbitration, including information collected or created to prepare the management position. G. Firearms Data LPrivat Minn. Stat. 13.36 14 Data about the purchase or transfer of firearms and applications for permits to carry firearms. H. Examination Data. Minn. Stat. 13.34 %A Completed versions of personnel and licensing examinations are private, unless the responsible authority determines that they should be confidential because access would compromise the objectivity, fairness, or integrity of the examination process. I. Elected Officials Corre6pondence (Private). nn. Stat. 13.33 1 Correspondence between individuals and elected officials, but either may make it public. J. Civil Investigation Data (Private Minn. Stat. 13.39 J.1 , % Data collected as part of an active investigation undertaken to commence or defend pending civil litigation, or which are retained in anticipation of pending civil litigation is confidential except that a complainant's statement is private. a K. Appraisal Diata (Confidential). Minn Stat. 13.50 !6 Appraisals made for the purpose of selling or acquiring land. L. Assessor's Data (Private' Minn. Stat. 13.51 R4-- X Data on sales sheets from private multiple listing service organizations. It Income information on individuals used to determine eligibility of property for classification 4c under (Minn. Stat. 273.13 Subd. 25(c)). .% The following data regarding income properties: 0 Income and expense figures for current year and past three years a Average vacancy factors for past three years a Net rentable or useable areas a Anticipated income and expenses for current year 0 Projected vacancy factor for current year 0 Lease information 1W Social security numbers (Minn. Stat. 13.49) M. Transportation Service Data LPrlvate). Minn. Stat. 13.521 1 Personal, medical, financial, familial or locational information, except name of applicants or users of transportation services for the disabled or elderly. N. Recreation Data (`Private). Minn. Stat. 13.57 U For people enrolling in recreational or other social programs; name, address, telephone number, any other data that identifies the individual, and any data which describes the health or medical condition of the individual, family relationships, living arrangements, and opinions as to the emotional makeup or behavior of an individual. 7. 0. Law Enfbrcement Data. Minn. Stat. 13.80 and 13.82 I, Data collected under the domestic abuse act is confidential. % The audio recording of a 911 call is private regarding the individual making the call, but a written transcript is public. !W Certain arrest data, request for service data, and response or incident data is public under Minn. Stat, 13.82. Otherwise, investigative data collected to prepare a case against a person for the commission of a crime or civil wrong is confidential while the investigation is active. Photographs which are part of inactive investigation files are private if they are clearly offensive to common sensibilities. Booking photographs are public. 1 The following are private: • The identity of undercover law enforcement officers • The identity of criminal sexual conduct victims • The identity of certain informants • The identity of victims, witnesses, people making a 911 call whose personal safety or property would be threatened by disclosure • The identity of a person making a 911 call to receive help in a mental health emergency it Unique descriptions of stolen, lost confiscated or recovered property are private. V Identities of customers of licenses, pawnshops and secondhand goods dealers are private. % Detention data which would disclose personal, medical, psychological or financial information or endanger an individual's life is private (Minn. Stat. 13.85). SA Criminal history data is private, except convictions of crimes within the past 15 years (Minn. Stat. 13.87) !W Deliberative processes or investigative techniques are: confidential. P. City Attorney Records. Minn. Stat. 13.30 The use, collection, storage, and dissemination of data by the city attorney is governed by statutes, rules, and professional standards concerning discovery, production of documents, introduction of evidence, and professional responsibty. Dat which is the subject of att,orney-client privilege is! confidentia Data which is thesubject of the "work product" privilege is confidential. I Q. Licensing Data. Minn. Stat. 13.41 Data contained in license applications and on licenses administered by local licensing agencies is all public data other than the social security number which is, private. R. Buildino Plans LBluenrint Documents l Minn. Stat. 13.37 I 1 0 HEO M=M 0 N H M I fill oil [W a RpriaJ14WI, U NIZA oil x"MM"T"M Residential building plans are considered public data if they do not contain security information, trade -secret information, and are not copyrighted. If the plans contain any of this information, they are considered non-public data. A. Public Data on Individuals....means that the information is available to anyone who asks to see it. B. Private Data on Individuals .... means that the information is available only to the person the information is about, and to the staff who must use it in the normal course of conducting city business. 91 A. Private and confidential information will be stored in files or databases which are not readily accessible to be secured during hours when the offices are closed. B. Private and confidential data must be kept only in City offices, except when necessary for City business. C. Only those employees whose job responsibilities require them to have access will beallowed access to files and records tM- ontain private or confidential information. These employees will be instructed to: Not discuss, disclose, or otherwise release private or confidential data to City employees whose job responsibilities do not require access to the data. Not leave private or confidential. data where non - authorized individuals might see Shred private or confidential data before discarding. D. When a contract with an outside party requires access to private or confidential information, the contracting party will be required to use and disseminate the information consistent with the Act. The City may include in a written contract the language contained in Exhibit 8. no LIVII a. Photocopy rate (Flat LRated................................. $ .15 per page b. Labor rate (research, assembly, computer services etc.) ............. $20.00 per hour (15 minutes minimum) c. 'Postage ...................................... Prevailing rate d. Microfilm services From film to hard copy ................. $ 1.0�0 per page (includes labor cost) e. Co in (dubbing) audio tapes.. $ 5.00 per tape (Audio tape to be provided by requester) f. Copying (dubbing) video to es - $10.00 per tape (Video tape to be provided by requester) g. Meeting Packets ........................ $ 7.00 per packet These rates are subject to change. The rates will be included in the fee schedule which is adopted by Council resolution, \\elkriver\sys\shrdoc\forms\infdiser.doc 11. DTII. Meeting Packet Request Form Meeting packet information is available at City Hall for public inspection at no charge. Copies of the complete packet or individual items from the packet are available at the rates listed below. Please fill out the following form and return with payment. Full packet requests must be made by 3 p.m. on the Wednesday preceding the meeting. Entire Packet Meeting packets are available on the Friday preceding the meeting. Upon receipt of payment, packets may be picked up on Friday after 4 p.m. If requested, packets will be mailed (we do not guarantee mailed packets will be delivered in time for meeting). Type of Meeting (ie, City Council, Planning Commission, etc. Date of Meeting #Packets Total x $7 = x$7- x$7= x$7= TOTAL x $7 = Individual Items Cost for individual agenda items (ie, memolback-up on a certain item) is $.10 per page up to 50 copies. A labor charge of $16.00 per hour will be included after 501 copies. (15 minutes minimum). Type of Meeting (ie, City Council, Planning Commission, etc. Date, of Meeting # Pages Total x $.10= x $.10 x $.10 x $.10 x $.10 x $.10 x $.10 TOTAL x $.10 Name: FAM -TOM Phone: \\forms\pktrqst.doc 12.