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.R *r <br /> , <br /> Sec.13.04 RIGHTS OF SIJB.TECTS OF DATA <br /> Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply privace or confidendal data concerniag himself shall <br /> be informed of: (a)the purpose and intended use of the requesud dara within the collecting'state agency,polidcal subdivision,or sratewide system; <br /> (b)whecher he may refuse oY is legally requued to supply the cequested data;(c)any�own consequence arising from his supplying or refusing to suppty <br /> private or confidencial data;and(d)the idendry of other persoat or enrides authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigaave dara,pursuant to secdon 13.82, subdivision 5,to a law enforcement o�cer. <br /> The commissioner of revenue mav place the nooce rewired under this subdivision in the individual income tax or propertv taz refund <br /> instrucdons instead of on those forms. <br /> Subd.3. Access to data by individual. 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 confidential. Upon his further request,an individual who is the subject <br /> of stored private or public dara on individuals shall be shown the dara wi[hout any charge to him and;if he desires, shall be informed of the content <br /> and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for <br /> si�c monrhs thereafrer unless a dispute or acdon pursuant to this secdon is pending or addiaonal 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 data. The responsible authority <br /> may require the requesdng person to pay the actual coscs 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 of <br /> the date of the request,ezciuding Saturdays,Sundays aad legal holidays,if immediate compliance is not possible. If he cannot comply with ihe request <br /> within that time,he shall so inform the individuai,and may have an addidooal 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 comptete. An individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shall nodfy in wridng the responsible authoriry describing the nature of the disagreemen[. <br /> The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomple[e and attempt to noafy past recipienu of <br /> inaccurate or incomplete data, inciuding recipiencs named by the individual; or(b)nodfy the individual thac he believes the dara 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 determinadon of the responsible authority may be appealed pursuant to the provisions of the adminisnative 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 fumish 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 /> 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 /> �::._ 7 , <br /> /Y � �� �' <br /> C�.:-�2GL � �t d �j �'"��✓,/= <br /> First Middle Last <br /> Address . <br /> C��y State Zip Phane <br /> I understand my rights as stated above. <br /> Signamre <br />