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<br /> Sec.13.04 RIGHTS OF SLIBJECTS OF DATA
<br /> Subd. i. Type of data. The rights of individuai on whom the data is stoced or to be sto�ed shall be as set forth in this secdon.
<br /> Subd.2. Information req�red to be given individual. An individual asked to supply private or confideadal dara concerning himself shall
<br /> be informed of: (a)the purpose and inrended use of the iequested data wichin the collecting§ta[e agency,poliucal subdivision,or sratewide sysum;
<br /> (b)whecher he may refuse oY is legally required to.supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
<br /> privace or confidendai data;and(d)the idendry of other penons or enrides au[horized by state or federal law to receive the daca. This requirement shall
<br /> not apply when an individual is asked to suppty invesrigadve dara,pursuant to secdon 13.82,subdivision 5,co a law enforcement o�cer.
<br /> The commissioner of re�enue mav place the nodce rewired under this subdivision in the individual income tax or provertv tax refund
<br /> instructions instead of on those forms. ., • , ,
<br /> Subd.3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject
<br /> of stored daCe on individuals,and whether it is class�ed as public,private or confidential. Upon his further request,an individual who is the subject
<br /> of stored p�ivate or public dara on individuals shall be shown the data without any charge.to him and,-if he desires, shall be informed of the content
<br /> and me�aing of that dafa. Afrer an individual has been shown the private data azid informed of i�s'me�uing,che data need not be disclosed to him for
<br /> six months thereafte[unless a disp�or acdon pursuanc w this secdon is pending or additional data on the individuai 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 rhe data. The responsible authoriry
<br /> may`require'the requesdng person to pay the actual costs of making',certifying;and compiling t1?e eopies.
<br /> The responsible authority shall comply immediately, if possible,with any request made pursuant co this subdivision,or within five days of
<br /> the date of the request,excluding Santrdays,Sundays and legal holidays,if immediate compliance is not possibte. If he cannot comply with the requesc
<br /> within thac dme,he shali so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,
<br /> Sundays and legal holidays. �, , , , , �' .',
<br /> Subd.4. Procedure when data is aot accurate or complete. An indiVidua�may contest tlie acCuracy or completeness of public or private
<br /> data conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authority describing�he nature of the disagreement.
<br /> The responsible au[hority 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 rocipients named by the individual;oc(b)nodfy the individual that he believes rhe data to be correct. Data
<br /> in dispuce shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
<br /> The decerminarion of the responsible authority may be appealed pursuant to the provisions of the administradve procedure act relating to
<br /> 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 request
<br /> for a pemut 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 are notified that:
<br /> ; 1., The information you furnish will be used to.determine your qualification for the permit or license requested.
<br /> � �. �ou may Yefuse to'supply data; but rzftisat may �equire 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 /> pubiic.
<br /> 5, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
<br /> 6. Ypur full mame is required to process this application or permit.
<br /> ��"�'eTo� � � � -!�.�J
<br /> First �1�ddle Lasc
<br /> 2 ��J ''�v`�
<br /> Address '!hn/ �3 � � /�_a,.,, �7�i�-2 Zt{�
<br /> 1/v'�-�'z��a--
<br /> Ciry State Zip Phone
<br /> I under's.t my4rights as stated above.
<br /> Signamr
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