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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 secdon. <br /> Subd.2. Information required to be given indiridual. An individual asked to supply private or co�dentia!data concerning himself <br /> shall be informed of: (a)the purpose and inte�ed use of the requested da[a within the coUecting state agency,poliacal subdivision,or sratewide <br /> system;(b)whether he may refuse or is legally required to supply the requested dara;(c)any known consequence arising from his supplying or <br /> refusing to supply private or confidendal data;and(d)the identiry of other persons or entiaes authorized by state or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to suppiy investigauve data,pursuant to secaon 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revernie mav nlace the norice rewired under thi subdivision in the individual income tax or orocertv tax refund <br /> instructions 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 <br /> subject of stored data on individuals,and whether it is classified as public,private or co�dential. Upon his further request,an individual who <br /> is the subject of swred private or public data on individuals shall be shown�e data without any charge to him and,if he desires,shall be informed <br /> of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six months thereafter unless a dispute or acaon pursuant to this section is pending�or addiaonal data on the individual has been <br /> coUected or created. The respo�uible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible authoriry may require the roquesting person w pay the actual cosu of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediauly,if possible,with any request made pursuant to this subdivision,or within five days <br /> of the date of the request,excluding Saardays,Sundays and legal holidays,.if unmediate compliance is not possible. If he cannot comply with <br /> the request within that ame,he shall so inform the individual,and may have an addirional five days within which to comply with the request, <br /> excluding Samrdays,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 <br /> private data conceming himself, To exercise this right,an individual shall noafy in writing the nsponsible authoriry describing the nanue of the <br /> disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found oo be inaccurate or uxomplete and attempt to noafy <br /> past recipieenc of inaccurate or ir�omplete data,ic�luding recipients named by the iadivrdual;or(b)notify the individual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of digagreement is included with the disclosed data. <br /> The deternunaaon of the responsible authoriry may be appealed puisuanc to the provisions of the administradve procedure act relating <br /> to 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 <br /> request for a permit or license from the �iry of Orono or any of its departments may require you to furnish certain <br /> private or confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determ.ine your qualification 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 eztent necessary to <br /> _ process the permit or Iicense. �� � <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 /> ��i4 i��•y �v►�'��t�... �r' c_�'I-�E"C.... <br /> First Middle Last <br /> /��.S� �v`�2G'.�.t�.. '�'"/�.. �tr , <br /> Address <br /> �f�Y�vt---r.ti► /jt,�' SS^�S�/ �^� �Z��3 <br /> C�ry State Zip Phone <br /> I understand my righis as stated above. <br /> Signature �"_ � ^ Q�"E..-5���' T <br /> . �'7"''�}^""�r ���h.Q.Jt,�i..v �"� �.�-KC_.. <br /> U <br />