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� <br /> � <br /> Sec.13.04 RIGATS OF SUB.TECTS 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 secdon. <br /> Subd.2. Information req�rired to be given individual. t1n individual asked w supply private or confidenaal data conceraing himself shall <br /> be informed of: (a)the pucpose and inrcnded use af the requesmd data within the collecting§tate agency,polidcal subdivision,or statewide system; <br /> (b)whether he may refuse ot is legally required to supply the requested data;(c)any known wnsequence arising from!us supplying or r�fusing to supply <br /> privau or confidential dara;and(d)the idenary of other pe�soas or entities suthorized by state or federal law to receive the data. This requirement shall <br /> aot apply when an individual is asked to suppty invesrigarive data,pursuant to secdon 13.82,subdivision 5,to a law enforcement o�cer. <br /> The commissioner of revenue mav alace the nodce rcwired under this subdivision in the individual income taz or vrovertv taz refund <br /> instrucdons inscead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is class�ed as public,private or contidenaal. Upon his further request,an individual who is t6e subject <br /> of stored private or public data on individuats shall be shown the data widiout any charge to him and;if he desires,shall be informed of the content <br /> and mr9��ng of that data. Afur an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for <br /> siz months thereafter unless a dispuu or acdon pursuanc to this secdon is pending or addi6oaal data on the individual has been collected or created. <br /> The responsible suthority shall provide copies of the privau or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,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 compliance is not possibte. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addirional five days within which to comply with the request,excluding Saaudays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeaess of public or private <br /> data conceming himself. To exercise this right,an individual s6all notify in writing che responsible authority describing the naturo of the disagreemenG <br /> The responsible authoriry shall within 30 days either: (a)correct the data found ro be inaccurace or incomplete and attempt to nodfy past recipienu of <br /> inaccucate or incomplete data,including recipients named by the individual;or(b)noafy the individual that he believes the data to be correct. Dara <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinaaon of the responsible authority may be appealed pursuant to the provisions of the adminisaadve procedure act relating to <br /> contesud 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 used to determine your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require ihat 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 <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 /> Fitst Middle �� <br /> Address • <br /> City State Zip Phone <br /> I understand my rights as stated above. <br /> Signature <br />