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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 shaU be as set ford►in this section. <br /> Subd.2. Infortnation required to be given individual.An individual asked to supply private or confidentisl data conceming himself sl�ll be <br /> infom�ed of: (a)the purpose and intended use of the requested data within the collecting state agency,polirical subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to suppty the requested data;(c)eny known consequence arising&om his supplying or refusiag to supply <br /> private or confidenrial data;and(d)the identity of other persons or entities suthorized by state or federal law to receive the data.This requirement shall <br /> not apply when an individual is asked to supply investigarive data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue ma�Rlace tl�e notice teauired under this subdivision in the individual income�c or pr��y�c refund <br /> inshuctions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon ra{uest to a responsible authority,an individual shall be infom�ed whether 6e is the subject of <br /> stored dats on individuals,and whether it is classified as public,private or confidential. Upon his fiuther tequest,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without azry charge to him and,if he desires,shall be informed ofthe content and <br /> meaning of that data. ARer en individual has been shown the private data and infortned of its meaning,t6e data need not be disclosed to him for six <br /> months thereafter unless a dispute or acdon pursuant to this section is pending or additional data on the individual has beea collected or created. T6e <br /> responsible authority shall provide copies of the private or public daffi upon request by ffie individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual costs of�king,certifying,and compiling the copies. <br /> The responsibte authority shall comply immediately,if possible,with siry request made pursuant to this subdivision,or within five days of <br /> tbe date of the request,excluding Saturdays,Sundays and legal holidays,if immediate complisnce is not possible.If he cannot comply with the request <br /> within that time,he shall so infortn the individual,and�y have an additional five days within which to comply with the tequest,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4.Procedure when data is not accurate or complete.An individuel may contest the accwacy or completeness ofpublic or private data <br /> concerning himself.To exercise this right,an individual shall notify in writing the respons�ble authoriry describing the nature ofthe disagreement The <br /> responsible suthority shall within 30 days either. (a)correct tl►e data found to be inaccuratc or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify tLe iedividual that he believes tfie data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The detemtinarion of the responsible suthority�y be appealed pursuant to the provisions of the administrative procedure act telating 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 fumish certain private or <br /> confidenrial information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualificarion for the pennit 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. T'he infonnation 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 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 youiself. <br /> 6. Your full name is required W process this application or permit. <br /> Qk� ��(lc� Ca��;L, �C�� <br /> First Middle Lsst <br /> r <br /> f�dP 38 <br /> ���� ,�, �� �� 3�^� � � ���'��-.>� <br /> City State Zip Phoue <br /> % <br /> I �erstand my ghts s stated . <br /> ignaterc <br /> Recet Fnrm ..,. <br />