TENNESSEN WARNING

As an applicant for benefits under one or more of the housing programs administered by Dakota County (the County), including but not limited to the Community Development Block Grant (CDBG) Program, you are being asked to provide information that may be considered private under the Minnesota Government Data Practices Act (the Act). The Act requires that you be provided with the following information.

The data that you will be asked to provide to the County for the Programs includes, but is not limited to the following: data about members of your household; income verification; identity of household members; and race and ethnicity. The foregoing information is needed in order to determine your eligibility for the Programs. You may refuse to provide the required information, but this may result in delay in processing or rejection of your application.

The information may be shared with applicable County staff, the U.S. Department of Housing and Urban Development (HUD), Minnesota Housing Finance Agency, local jurisdictions implementing emergency assistance programs (Hennepin County, Anoka County, Washington County, Ramsey County, the City of St. Paul, the City of Minneapolis), the United States Department of Treasury, the program administrators and contractors, community agencies funded from state, federal and local resources that help provide housing assistance, the organization(s) identified as holding debt for which you are seeking assistance, and internal and independent auditors. It may also be released to appropriate Federal, State, and local agencies when relevant, to civil, criminal, or regulatory investigations.

MN PRIVACY ACT NOTICE

As an applicant for the Programs, you may be asked to provide your social security number. If it is requested, the federal Privacy Act of 1974 requires that you be provided with the following information:
- Furnishing your social security number may be mandatory in order for the Programs to determine your eligibility for the Programs.
- The statutory authority for the Programs to request disclosure of your social security number is Title 42, Chapter 7, Subchapter II 405(c)(2)(C)(i),