Exemption from Public Records Requests Privacy Test Questionnaire

Florida law protects certain personal information for some positions such as law enforcement officers and their spouse and children. This means specific employee information is exempt from public records requests. An excerpt of the Florida Statutes addressing these and other exemptions that may be of interest to you is attached.

To protect DMS employees as provided by Florida Statute, we are updating the privacy indicators in People First. Currently, there are no positions within DMS that are exempt from public records. However, if you previously held an exempt position, the following People First data is exempt from a public records request:  home address  mailing address,  temporary address  personal telephone number(s)

If you are the spouse or child of someone currently or previously in an exempt position, the following People First data is exempt from a public records request:  home address  mailing address  temporary address  personal telephone number(s)  work location address  work mailing address

All DMS employee’s Social Security Numbers are always protected and will never be released in a public records request.

By completing the attached questionnaire you can easily determine if any of the exemptions apply to you.

Complete a new form ONLY IF you have had a change in your status or in the information contained on the questionnaire. If no information has changed, you do not need to complete a new form. If you have had changes since the last time you completed a privacy indicator, please complete, sign and return to DMS Human Resources. You may:

 FAX: (850) 921-5427  Scan and e-mail as an attachment to: [email protected]  Hand deliver or send by inter-office mail or U.S. mail: DMS Human Resources 4050 Esplanade Way, Suite 260 Tallahassee, FL 32399-0950.

Page 1 of 2 HR-110-F1 Employee Privacy Test Last Revised: 04/05/2011 DMS Employee Privacy Test Questionnaire

A response is required from all DMS employees. Please answer each question by placing an ‘X’ in the YES or NO column. Question Yes No 1 Are you currently or have you ever been a law enforcement employee, including a correctional officer or a correctional probation officer? Are you the spouse or child of the above? 2 Are you currently or have you ever been an employee of the Department of Children and Family Services whose duties include the investigation of abuse, neglect, exploitation, fraud, theft, or other criminal activities? Are you the spouse or child of the above? 3 Are you currently or have you ever been an employee of the Department of Health whose duties are to support the investigation of child abuse or neglect? Are you the spouse or child of the above? 4 Are you currently or have you ever been an employee of the Department of Revenue or local governments whose responsibilities include revenue collection and enforcement or child support enforcement? Are you the spouse or child of the above? 5 Are you a firefighter certified in compliance with FL Statutes 633.35? Are you the spouse or child of the above? 6 Are you a justice of the Supreme Court, district court of appeal judge, circuit court judge, or county court judge? Are you the spouse or child of the above? 7 Are you currently or have you ever been a state attorney, assistant state attorney, statewide prosecutor, or assistant statewide prosecutor? Are you the spouse or child of the above? 8 Are you currently or have you ever been a human resource, labor relations, or employee relations director, assistant director, manager, or assistant manager of any local government agency or water management district whose duties include hiring and firing employees, labor contract negotiation, administration, or other personnel-related duties? Are you the spouse or child of the above? 9 Are you currently or have you ever been a United States attorney or assistant United States attorney? Are you the spouse or child of the above? 10 Are you currently or have you ever been a judge of United States Courts of Appeal, United States district judge, or United States magistrate judge? Are you the spouse or child of the above? 11 Are you currently or have you ever been a code enforcement officer? Are you the spouse or child of the above? 12 Are you currently or have you ever been a guardian ad litem, as defined in FL Statutes 39.820? Are you the spouse or child of the above? 13 Are you currently or have you ever been a juvenile probation officer, juvenile probation supervisor, detention superintendent, assistant detention superintendent, senior juvenile detention officer, juvenile detention officer supervisor, juvenile detention officer, house parent I or II, house parent supervisor, group treatment leader, group treatment leader supervisor, rehabilitation therapist, or social services counselor of the Department of Juvenile Justice? Are you the spouse or child of the above?

If you answered YES to one of the above questions but you want your information published anyway, sign your name here: ______

I certify the above information is true and correct to the best of my knowledge.

Print Your Name: ______

Sign Your Name: ______Date: ______

Page 2 of 2 HR-110-F1 Employee Privacy Test Last Revised: 04/05/2011