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Sec.13.04 RIGHTS OF SLJBJECTS OF D:�TA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forch in this secdon. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial data concerning himself shall <br /> be informed of: (a)�he purpose and inrended use of the requested dara within the collecdng'state agency, poliacal subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any Imown coasequence arising from his supplying or refusing to supply <br /> private or confidendal data;and(d)the idendry of other penoas or enriaes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesdgadve dara, pursuant to section 13.82,subdivision 5, to a law enforcement o�cer. <br /> The commissioner of re�•enu� mav place the nodce reauired under this subdivision in the individual income tax or Dropertv raz refund <br /> instruccions instead of on those forms. <br /> Subd.3. Access to data by individuai. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as public, private or co�dendal. Upon his further request,aa individual who is the subject <br /> of stored private or public data on individuals shall be shown che data wi[hout any charge to him and,�if he desires,shall be informed of the contenc <br /> and meaning of[hat data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hicn for <br /> six months thereafter unless a dispute or acrion pursuanc to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the da[a. The responsible authoriry <br /> may require the requesting person to pay the actual cosu of makin2,certifying,and compiling the copies. <br /> The responsible authority shall comply immediate(y, if possible, with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and(egal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shail so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An mdividuaf may contest the accuncy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shail norify in writing the responsible authoriry describing[he nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, including recipients named by the individual;or(b)noafy 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 /> T'he decerminadon of the rzsponsible authority may be appealed pursuant to the provisions of the administracive procedure act relaang to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri�hts 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 /> confiden[ial information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the perm.it or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the permit or Iicense. <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 perm.it 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 perm.it. <br /> �1Z � �_ � `���+��c<� C;�-►2-r-c-� <br /> First Middle Last <br /> /3 j v �2 �--�`T �0 i•cJ'( /_� <br /> Address <br /> 6F2v�t/o �l� ,��5%�`� ZS2 - `l�7z_ ��za �' <br /> City State Zip Phone <br /> __,_ r�=,�r.�,,,d_m}c_rig_hts as stated above. ___.._______ <br /> � � .--'-�_ � . <br /> Signature <br />