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004:1: 03#811 <br />Minnesota Statutes, section 13.04, "Rights of Subjects of Data" requires that when an <br />individual is asked to supply private or confidential data concerning himself or herself, he or she <br />must be given certain information about why we need the data and how we will use it. <br />In order to draft a "Tennessen Warning" which meets the requirements of Minnesota <br />Statutes, sections 13.04, subdivision 2, 13.05, subdivision 8 and other provisions of the Data <br />Practices Act, please complete the following: <br />1. Name of department and contact person. <br />2. Briefly describe the purpose and intended use of the information you are requesting. <br />3. Can the individual refuse to supply any of the requested information or is the information <br />required? If the data is legally required, what is the authority (i.e., court order, statute, or federal <br />law)? <br />4, What are the known consequences to the individual of supplying the requested data? <br />(Examples: employment or program eligibility) <br />5. What are the known consequences to the individual of refusing to supply the requested <br />data? (Examples. contempt of court, eligibility for employment or program participation) <br />CA 50884 <br />GA115-26 <br />