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. <br /> Sec.13.04 RIGHTS 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 forth in this section. <br /> Subd.2. Informarion required to be given individual.An individual asked to supply private or confidential data conceming himself shall be <br /> informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identiry of other persons or entities authorizal by state or federal law 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 enforcement officer. <br /> TI►e commissioner of revenue may olace the notice reguired under th�s subdivision in the i dividual' come tar or procerty t�refiLnd <br /> instructions mstead of on tho�forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or confidenNaL Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals s6a11 be shown the data without siry charge to him and,if he desires,shall be informed ofthe content and <br /> meaning of that data. After an individual has been shown the private data and infornied of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. 1'he <br /> responsible suthority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authority <br /> may require the requesting person to pay the actual costs of making,certifying,and compiling t6e copies. <br /> The responsible authority shall comply immediately,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 legal holidays,if imtnediate compliance is not possible.If he caonot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which to comply witt►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 /> conceming himself. To e�rercise this right,an individual shall notify in writing the responsible authority describing the nature of U►e disagreement.The <br /> responsible suthority shall within 30 days either: (a)correct the data found to be inaccurace or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)norify the individual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individuaPs statement of disagreement is included with the disclosed data. <br /> The determination ofthe responsible suthority may be appealed pursuant to the provisions of the administrative 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 permit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential informarion. <br /> You are notified that: <br /> 1. The information you furnish will be used to deteimine your qualificarion 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 shazed 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 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 /> IG.G M1�. f c+ v�Suv� �S 'L_ <br /> Firat Middle Iatat <br /> � 1�a Qh:�.�I�,,, (�/�y <br /> Address <br /> or��� � � 5���3�� �/� ,9l ��7�? <br /> C�tY State Zip P6one <br /> I understand my ts as stated bove. <br /> gnatare <br /> RPcrr F�rm ,,,, <br />