Required fields are marked with asterisks (*)

Welcome

To request data as the data subject, you must show a valid ID as noted on this form. Individuals who do not exercise their data practices rights in person must provide notarazed or certified copies of the documents that are required.

I am requesting access to data in the following way:
 

Type of Identification Provided: ____________________________

State of Minnesota

County of ______________________

I verified the identification of the requestor/data subject on _________________[date] by ___________________________________[name].

[Seal, if any]                       

                                                                                                                                                         ___________________________________________

                                                                                                                                                          Signature of notary

                                                                                                                                                           My commission expires: ______________________

Standards for Verifying Identity

The following constitute proof of identity:

  1. An adult individual must provide a valid photo ID such as
    1. state driver's license
    2. military ID
    3. passport
    4. Minnesota ID
    5. Minnesota Tribal ID
  2. A minor individual must provide a valid photo ID such as
    1. state driver's license
    2. military ID
    3. passport
    4. Minnesota ID
    5. Minnesota Tribal ID
    6. Minnesota school ID
  3. The parent/guardian of a minor must provide a valid photo ID as noted above and either
    1. a certified copy of the minor's birth certificate or
    2. a certified copy of documents that establish the parent/guardian's relationship to the child such as
      1. a court order relating to divorce, separation, custody, fosther care
      2. a foster care contract
      3. an affidavit of parentage
  4. The legal guardian for an individual ust provide a valid photo ID and a certified copy of appropriate documentation of formal or informal appointment as guardian such as court order or valid power of attorney.

 



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