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. <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.1. Type of data. T6e rights of individual on w6om the data is stored or to be stored shall be as set forth ln this section. <br /> Subd.2. In[ormation required to be given individual. An individual asked to supply private or contidential data concerning himself s6a11 be <br /> informed of: (s)the purpose and intended use of the requested data within the rnllecting state agency,political subdlvision,or statewide system;(b) <br /> whether he may refuse or is legally requtred to supply the requested data;(c)any known consequence arising trom hls supplying or refusing to supply <br /> private or contldentisl dsta;and(d)the identity of other persons or entities suthorized by state or federal Iaw 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 s law enforcement oft7cer. <br /> The commissioner of revenue mav nlace the nodce reauired under this subdivision in the individual lncome tax or orooertv ta�refund <br /> instructions instead of on t6ose forms. <br /> Subd.3. Access to data by indlvidual. Upon requesf to a respoosible aut6ority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whet6er it is classitled ss public,private or rnnfidential. Upon his further request,an individual who is the subject of <br /> stored prlvate or public data oo individuals shall be shown the data without any charge to him and,if he desires,shsll be informed of the content and <br /> meaning of that data. After an individual has been shown the private data and iniormed of its meaning,the data need not be disclosed to him for six <br /> months thereafter uoless a dispute or actton pursuaot to this section is pending or additional data on t6e indlvidual has been collected or created. T6e <br /> responsible suthorlty shall provide rnples of the private or publlc data upon request by the indivldual subject of t6e data. The responsible authority may <br /> require the requesting person to pay the actual costs of making,certifying,and rnmpiling the copies. <br /> The responsible suthority shall comply immediately,if possible,with any request made pursuant to thls 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 6e cannot comply with the request within <br /> that time,he shall so inform t6e individual,and may have an addltional tive days within which to rnmply with the request,excluding Saturdays,Sundays <br /> and legal holidays. <br /> Subd.4. Procedure wheo data is not accurate or complete. An individual may rnntest the accuracy or completeness otpublic or private data <br /> concerning himself. To eaercise this right,an indivldual shall ootify In wriUng the responsible authority descrlbing the nature of the disagreemen�The <br /> respooslble suthority shall wit6in 30 days either: (a)correct the dsta found to be inaccurate or inrnmplete aad attempt to notify past recipients of <br /> inaccurate or incomplete data,including reciptents oamed by the indlvidusl;or(b)notify the individual that he believes the data to be correct Data(n <br /> dispute shall be disclosed only if the Indlvidual's statement ot disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to <br /> rnntested 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 information you furnish will be nsed 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 eztent 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 <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 /> Ti•riv �v �o /!�7 �C Tl`�/'/��r- <br /> First Middle Last <br /> zo3 z, �5'h.aa�Nc.�.oe d �� <br /> Address <br /> o�^o.�� lh.r� s:S'33� �l�—�60 �o,si� �c�!l� <br /> City State Zip Phone <br /> I understand my rights as stated above. - <br /> � <br /> gna u e <br />