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COMBINED MANUAL

ISSUE DATE 09/2008

CLIENT RIGHTS - DATA PRIVACY PRACTICES

0003.09.06

When you ask people to provide private or confidential data about themselves, you must tell them:

● The purpose and intended use of the requested data.

● Whether they may refuse or if the law requires them to supply the data.

● The consequences of supplying or refusing to supply the data.

● The identity of other people or entities authorized to receive the data.

The Combined Application Form (CAF) (DHS-5223) (PDF) contains some of this information. More information is on the form Notice of Privacy Practices (DHS-3979) (PDF).

Include a signed copy of the Combined Application Form (CAF) in the case file to document that you gave the client a Notice of Privacy Practices. Also see 0005.09 (Combined Application Form (CAF)).

For other questions related to data practices, write to the Data Practices Attorney:

DHS Data Practices Attorney P.O. Box 64998 St. Paul, Minnesota 55164