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Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subcf. 1. Type o[data. The rights of individual on whom the data is stored or to be sto�ed shall be as set focth in this section. <br /> Subd.2. Informatlon required to be�ven i�lvidual. An individusl asked to supply private or confidential data conceming himself shall <br /> be informed of: (a)the putpose and intended use of the requested data within the collecting S�te agency,poliacal�bdivision,or statewide system; <br /> (b)whether he may refuse or is legally requieed to supply the requested data;(c)any Imowa consequence arising from his supplying or nefusing to supply <br /> private or confidential daca;and(d)the identity of other persons or entiaes authorized by staoe or fedeial law to�eceive the data. 1Lis requirement shall <br /> not apply when an individual is asked to suppty investigative da�,pursuant to section 13.82,sutidivision 5,to a law enfo�ement officer. <br /> The commissioner of revemie mav ulace the notice reauired under this subdivision in the individual inwme tax or orocertv tax refu� <br /> instiucaons insuad of on those forms. <br /> S�bd.3. Access to data by individual. Upon req�est to a responsible authoriry,an individusl shall be infocmed whether he is the subject <br /> of sbored data on individuals,and whether it is classified as public,private or confidential. Upon his funher request,aa i�ividual who is the subject <br /> of stored private or�bHc data on individuals shall be shown the data without any charge to him a�,if he desires,shall be informed of the content <br /> a�meaning of that data. After an individual has bcen shown d►e private data and info�of its meaning,the data need not be disclosed to him for <br /> six months thereafoer unless a dispute or action pursuant to this secdon is pending or additional data on the individual has been collected or creaoed. <br /> '!he responsible authority shall provide copies of the private or public data upon mquest by the individual subject of the data. The rosponsible authority <br /> may require the requesting pecson to pay We acwal costs of maldng,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any iequest made pursvant to this subdivision,or within five days of <br /> the date of the tequest,ezcluding Saturdays,Stindays and legal holidays,if immediau compliance is not possible. If he cannot comply with the request <br /> within that time,6e shall so inform the individual,and may have an additionai five days within wlrich to comply with the ceq�est,excluding Satuidays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is�t acc�ate or c�pl�e. An individual may contest the accuracy or completeness of public or privau <br /> ' data concerning himself. To ezercise this right,an individual shall�ufy in writing the respons�le authority descnbing the nawre of the disagreement <br /> The responsible authoriry shall within 30 days either: (a)correct the data fou�d ro be inaccurate or incompteu and ammpt oo notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement 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 procedure act relating W � <br /> conusted 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 request <br /> for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You aze notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license 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 process <br /> the permit or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become <br /> publia <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 /> M,�4/L4�. � .s����`'t-6-F��2r� <br /> First Middle Lasc <br /> 7 L'7'T S i.��tc��`�-�C`�C'��t� �t7 <br /> Address <br /> w-�-���� ,� �s 3�r � <br /> Ci�y State Zip Phone <br /> I understand my rights as stated above. <br /> signawre <br />