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Sec.13.04 RIGHTS OF SIIBJECTS OF D�TA <br /> Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be sto�d shall be as set fotth in this secdon. <br /> Subd.2. Information required to be given indiridual. An individual asked ro supply private or confidendal data concerning himself shall <br /> be infoaned of: (a) the purpose and intended use of the requesced data within the colleccing'state agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse or is(egally required to supply the requested data;(c)any l�own consequence arising from his supplying or refusing to suppty <br /> private or confidenaai data;and(d)che identiry of other persons or enrides authorized by state or fedecal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrigaave data, pursuant to secoon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of revenue mav place the noace required under this subdivision in the individual income tax or propertv tax refund <br /> �--� instrucrions instead of on those forms. <br /> � <br /> J\ L' � Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shal(be informed whether he is the subject <br /> Mci�-. <br /> �N; ; of stored data on individuals, and whe[her it is classified as public, private or confiden[ial. Upon his further request,an individual who is the subject <br /> �r� �� of stored private or pubtic data on individuals shall be shown the data wi[hout any charge to hun and, if he desires, shall be informed of the content <br /> ,''� and meaning of that data. After an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or action pursuant to this secdon is pending or additional data on the individual has been collecred or creaced. <br /> The responsible authoriry shall provide copies of the private or pubtic data upon request by the individual subject of the data. The respoosible authoriry <br /> may require the requesting person to pay the actual costs of making, cerdfying, and compiling the copies. <br /> The responsible authoriry shall compiy immediately, if possible, with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so infornt the individual,and may have an addidonal five 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 contes[the accuracy or completeness of public or private <br /> data concerning himself. To exercise[his right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreemen[. <br /> The responsible authoriry shall within 30 days ei[her: (a)correct the data found to be inaccurate or incomplete and attempt to noafy past recipients of <br /> inaccurate or incomplete data, including recipiencs named by the individual; or(b) notify [he individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsib(e authority may be appealed pursuant to the provisions of the administrative procedure act relating to <br /> contesced cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Riehts of subjects of data", we would like to inform you that your request <br /> for a pernut 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 /> 1. T'he information you furnish will be used to detemune your qualification for the pemut or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the Ciry 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 pernut or license. <br /> 4. If your requested pernut 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 fuil name is required to process this application or permit. <br /> � <br /> i��� 4���(� � � ��L �Or�'rl�i <br /> p�rs� Middle Lasc <br /> ���'�� ��-1�y wvo L P�v <br /> � Address � �'v'�r� ,�i�C� l � ���� "�7�'�j <br /> �vl ������ � — <br /> C��, State Zip Phone <br /> I understand my rights as stated above. ---- <br /> , - � � <br /> �IF �y//�/ � `l l, ^�/� � � <br /> 1/,�, ,_ <br /> , <br /> sign� <br />