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Sec13.04 RIGH7'S OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set tbrth in this section. <br /> Subd.2. Information required to begiven individual An individual asked to supply private or contidential data conccrning himselfshall be <br /> informed of: (a)the purpose and intended use of the requestcd data within the collecting state 2gency,political subdivisiai,or statewide system;(b) <br /> whether he may refusc or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or contidential data;and(d)thc identity of othcr persons or entities authorized by state or federal la���to receive the data.This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforceinent ot�ticer. <br /> I�he commissioner of revenue mav place the notice required under this subdivision m the individual income tax or propertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3 Access to data by individual. Upon raquest Lo a responsible authority.an individual shall be in(ormed whether he is thc subjectof <br /> stored data on individuals,and whether it is classified as public,private or contidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data witho�u any charge to him and,if he desires,shall be intonned of the content and <br /> meaning of that data. Atter an individual has becn shown the private data and infonned of its meaning d�e data need not be disclosed to him for sis <br /> months thereaRer unless a dispute or action pursu�nt to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copics of the private or public data upon request by the individual subject of the data. The responsible�uthority <br /> may require the requesting person to pay the actual costs of making,certitying.and compiling the copies. <br /> The responsible authorit�shal I compl� immediately.it possible,with any request made pursuant to this subdivision,or within tive days of <br /> the date of the reyuest,e.ccluding Salurdays,S�inuay�and Icgal h��liday;,if in��inediate coinpliance is not pos;ible. If he ccnnot aomply witl�tl�e request <br /> within tl�at time,he shall so infonn the individual,and may have an additional tive 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 individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To e�ercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreemenL The <br /> responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual thathe believes the data to be correct. Uata in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The detennination ofthe responsible authority may be appealed pursuant to the provisions ofthe administrative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance�vith M.S. 13.04,Subd.2,"Rights oPsubjects of data",we�vould like to inform you that your request <br /> for a permit or licensc trom the City of Orono or any of its departments may require you to furnish certain private or <br /> conYidential information. <br /> You are notitied that: <br /> I. The infonnation you 1�urnish will be used to deterinine your qualitication 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 liccnse rcquires Council action to approve, some information may become <br /> public. <br /> �. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. <br /> 6. Yow•full name is required to process this application or permit. <br /> � �t vf E�-�wo�-� l�/cw�lz�. <br /> � � <br /> First Middle Last <br /> ��:? �� 1 U 3'� �"� <br /> �ess <br /> �'e�� /�►-^� J a" ��� 51"z �Yu z r�,� <br /> City State Zip Phone <br /> I under nd rig as stated above. <br /> Si ature <br /> Rcsct Form 32 <br />