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i � <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA • , <br /> Subd. 1. Type of data. The rights of i�uiividual on whom the data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supply privau or co�dential data conceming himself <br /> shall be informed of: (a)the puipose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or <br /> refusing ro suppiy private or confidenaal data;and(d)the identiry of other persons or en6ties authorized by state or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply invesdgaave data, pursuant to section 13.82, subdivision 5, to a law <br /> enforcement o�cer. <br /> The commissioner of revenue mav olace the norice reauired under this subdivision in the individual income taz or nrocertv tax refund <br /> instrucdons instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request ro a responsible authority,an individual shall be informed whether he is the <br /> subject of stored data on individuals,and whether it is class�ed as public,private or confidendal. Upon his further request,an individual who <br /> is the subject of swred private or public data on individuals shall be shown the data wirhout any charge to him and,if he desires,shall be informed <br /> of the content and meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be <br /> disclosed w him for six mondu thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days <br /> of the date of the request,exclnding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with <br /> the request within that time,he shall so inform the i�ividual,and may have an additional five days within which to comply with the request, <br /> excluding Saturdays,Sundays and legal holidays. <br /> S�bd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or <br /> private data conceming himself. To exercise this right,an individual shall nofify in writing the responsible authoriry describing the nature of ihe <br /> disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found oo be inaccurate or i�omplete and attempt to notify <br /> past recipients of inaccurate or i�omplete dara,including recipients named by the individual;or(b)nodfy the individual tUat he believes the daha <br /> to be correct. Data in dispute shall be disclosed only if the individual's sratement of disagreement is included with the disclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative prceedure act relating <br /> to contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your <br /> request for a permit or license from the�iry of Orono or any of its departments may require you to furnish certain <br /> private or confidential information. <br /> You are notified that: � <br /> 1. The information you fumish will be used to determine your qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to <br /> process the permit or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. <br /> 6. � Your full name is required to process this application or permit. -^ <br /> ��-2c�L� c.c..l� ��_ t��—. 1-' i �..1� ��� <br /> First Middte Last <br /> �(��3� � o � �� 2t» � �sL <br /> Addres <br /> ��., �,u�.� /�� ,�� SS�'�`�Z- .s�9 c� �a Z <br /> Ciry State Zip Phone <br /> I understand rights as stated ove. <br /> � <br /> Signam <br /> � 6 <br />