2021.07.27 CC Packet v.3 - Laserfiche WebLink

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OFFICE USE ONLY: Staff member processing the request: PRINTED NAME DEPARTMENT DATE COMPLETED Classification of Data Requested: ❑ Public Data ❑ Private or Nonpublic Data** ❑ Confidential or Protected Nonpublic Data** ❑ Data of Mixed Classifications** ** Please consult with the Compliance Official or Responsible Authority prior to release. Staff verification (private or nonpublic data only) *** Name of Requestor: ID Type: Number: ***The following constitute proof of identity. • An adult individual must provide a valid photo ID,such as o a state driver's license o a military ID o a passport o a Minnesota ID o a Minnesota tribal ID • A minor individual must provide a valid photo ID,such as o a state driver's license o a military ID o a passport o a Minnesota ID o a Minnesota Tribal ID o a Minnesota school ID • The parent or guardian of a minor must provide a valid photo ID and either o a certified copy of the minor's birth certificate or ■ a certified copy of documents that establish the parent or guardian's relationship to the child,such as a court order relating to divorce,separation, custody,foster care;a foster care contract;or, an affidavit of parentage • The legal guardian for an individual must provide a valid photo ID and a certified copy of appropriate documentation of formal or informal appointment as guardian,such as a court order(s)or valid power of attorney Note:Individuals who do not exercise their data practices rights in person must provide either notarized or certified copies of the documents that are required or an affidavit of ID. Policy and procedures required by Minnesota 10 Statutes,sections 13.025 and 13.03 (2016)