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. t , <br /> �. <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.l. Type ot 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. Intormation required to be given indlvidual. An individual asked to supply prtvate or contidential data concerning h(mself shall be <br /> informed of: (a)the purpose and intended use ot the requested data wlthin the collect(ng 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 supplying or refusing to supply <br /> private or confidential data;and(d)the identity of other persons or entlties authorized by state or federal law to receive the dats. This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to sect(on 13.82,subdivision 5,to a Iaw enforcement officer. <br /> The commissio�er of revenue mav ulace the notice reauired under this subdivision in the individual income tax or urooertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by indivldual. Upon request to a responsible authority,an individual shall be informed whether he Is the subject of <br /> stored data on i�dividuals,and whether It is classified as public,private or confidential. Upon his further request,an Individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without any charge to him and,it he desires,shall be informed of the content and <br /> me$ning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to htm for six <br /> months thereafter unless a dispute or action pursuant to this section(s pending or additional data on the individual has been collected or created. The <br /> responstble authority shall provide copies of the private or public data upon request by the individual subject of the data.The responsible authority may <br /> require the requesting person to pay the actual costs of making,certifying,and compiling the coples. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within eve days of the <br /> date ot the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot comply with the requestwithin <br /> that time,he shall so intorm the individual,and may have an addltional five days within which to comply with the request,excluding Saturdays,Sundays <br /> and legal holidays. <br /> Subd.4. Procedure when datu is not accurate or complete. An individual may contest the accuracy or completeness of public or private data <br /> concerning himselL To exercise this right,an individual shall notify in writing the responsible authority describing the nature otthe disagreement The <br /> responsfble suthority shall within 30 days either: (a)correct the data found to bc inaccuratc or incomplete and attempt to notify past reciptents of <br /> inaccurate or inrnmplete data,Including recipients�amed by the indlvidual;or(b)nodfy the indiv(dual that he believes the data to be correc4 Data in <br /> dispute shall be disclosed only if the individual's statement of disagrecment is inciuded with the disclosed data. <br /> The determ(nation of thc responsiblc$uthortty may be appealed pursuant to the provisions of the 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 /> con�dential 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 that 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 /> �4u�S� <br /> First Middle Last <br /> Address� - <br /> � ,... <br /> City State Zip Phone <br /> I understan my ri as ted bove. <br /> Signature <br />