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Sec.l 3.04 RIGFfTS OF SUBJEC7'S OF DATA <br /> Subd. I. 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. Informatlon required to be given individual. M individual asked to supply private or confidential data concerning himself shall be <br /> informed of: (a) the purpose and intended use of the requested data within the coliecting state agenty, political subdivision, or statewide system; (b) <br /> whether he may reFuse or is legally required to supply the requested data; (c) any known rnnsequence arising irom his supplying or refusing to supply <br /> private or con�dential data; and (d) the identity of other persons or entities authorized 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 /> The commissioner c�f revenue ma lace the notice re uired under this subdivision in the individual income tax or ro tax refunJ <br /> instructions ins�ead o(on ihose formc. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authority, an individual shall be informed whether he is the subjed o( <br /> stored data on individuals,and whether it is classlfied as public, private or confidential. Upon his further request, an individual who is the subjeM of stored <br /> privale or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the content and meaning <br /> o( ihat data. ANer an individual has been shown the private data and informed of its meaning, the data need not be disclosed to him for six months <br /> thereafler unless a dispute or action pursuant to this section is pending or additional data on the individual has been collec�ed or created. The responsible <br /> authority shall provide copies of the private or public data upon request by ihe individual subject of the data. The responsible authority may require the <br /> requesting person to pay the adual rnsts of making,certifying,and compiling the copies. <br /> The responsible authority shall rnmply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the <br /> date of the request, excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within <br /> that time, he shall so inform the individual, and may have an additional five days within which to comply with the request, ezcluding Salurdays, Sundays <br /> and legal holidays. <br /> Subd. 4. Procedure when data is not accurate or complete. M individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right, an individual shall noti(y in writing the responsible authority describing the nature of the disagreement. <br /> lhe responsible authority shall within 30 days either: (a) rnrrect the data found to be inaccurate or incomplete and attempt to notify past recipients o( <br /> inaccurate or incomplete data, includ'ing recipients named by the individual; or (b) notify the individual that he believes the data to be coneM. Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions o( the administrative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Rigfits 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 information. <br /> You are notified that: <br /> I. 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 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 /> �� � � i1 1 1�P��� <br /> F�( 7 � � 'i�Q.1/l/1,(• hlid e Las� <br /> �����f�1 A � <br /> dress <br /> ��a--�n � o � M� SSZj�Q� <br /> Gty State Zip Phone <br /> I understa y ri as d ab ve. �� <br /> Signatu <br />