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t <br /> Sec.13.04 RIGHTS OF SUBJEC'CS 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.Information required to be given individual.An individual asked to supply private or wnfidential data conceming himself shall be <br /> informed o£ (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 supplyingor refusing to supply <br /> private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.1'his requirement shall <br /> not apply when an individua)is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue ma�place the notice required under this subdivision in the individual income tax or procerty tau refund <br /> instnictions instead of on those forms. <br /> Subd.3. Access to data by individual.Upon request to a responsible authority,an individual shal l be informed wheiher he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or confidential. Upon his fuRher request,an individual who is the subject of <br /> stored private or publ ic data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and <br /> meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six <br /> months thereafter miless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsibte authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible audiority shall comply immediately,ifpossible,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 immediate compliar�ce is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,a�d may have an additional 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 contest the accuracy or completeness of public or private daca <br /> concerning himself.To eaercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement.The <br /> responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individuat;or(b)notify the individual that he believes the 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 determination of the responsible authority may be appealed pursuant to the provisions of[he 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 information. <br /> You are notified that: <br /> 1. The inforniation you furnish will be used to determine 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 e�ctent 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. ]3.04(available upon request)to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> Firsi�/%%%���� �le LAst <br /> L4��, <br /> Address <br /> .�'�G G /.�/�i� �Iv� ✓J ,/�1�/ �5.��1 �„�.�-S��a� <br /> City State Zip Phone <br /> I understand ights tated above � <br /> Sign3ture <br /> 32 <br />