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y� � <br /> Sec,13.04 RIGHTS OP SUBJECTS OF DATA <br /> Subd. I. Type of data. The righ[s of individual on whom[he data is stored or[o be stored shall be as set fortlt in this se:tion. <br /> Subd.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himself shall be <br /> informed of: (a)the purpose and intended use of the requested data tvithin the collecting state agency,political subdivision,or statewide syscem;(b) <br /> whether he may refuse or is 1ega11y required to supply the requested data;(c)any known consequence arising fram his supplying or refusing to supply <br /> private or confidential data;and(d)the identiry of ocher persons or entities authorized by state or federal law to receive the data.This requirement shall <br /> no:apply when an individual is asked[o suoply investigative data,pursuant to section 13.32,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav o11ce the notice required under this subdivision in the individual income ta�or propertv tax refund <br /> instructions inscead of on those ferms. <br /> Subd.3. Access to data by individual. Upon request to a responsible aucttority,an individuzl shall be informed«�hether he is[he subject of <br /> stored data on individual5,.and whether it is classified as public,priva[e or confiden[iat. Upon his further request,an individual who is the suoject o: <br /> stored private or public data on individuals shall be shawn the data without any charge to him and,if he desires,shall bz informed of�he content and <br /> meaning of that daca. A$er an individua]has been shown the pnvate data and informed of its meaning,the data need not be disclosed[o him for siz <br /> months[hereafter unless a dispute or action pursuant to this section is pending or additional data on the individua!has been coltected or created. The <br /> responsible auchority shall provide copies of the pnvate or pubGc data upon requcst by the individual subject of the datz. The responsible authority <br /> may require the requesting person to pay che acr�al costs of making,certiiying,and compiling the copies. <br /> The responsible authority shai]comply immediately,if possible,wich any requesc made pursuant to this subdivision,or wi:hin five days o: <br /> the date of the reques[,e�cluding Sa[urdays,Sundays and legal holidays,if immediace cornpliance is not possible. If he cannot comp!y�vith the reques[ <br /> within[hat[ime,he shall so iniorm the individuat,and may have an additional five days widiin which to comply with the request,excludin�Sarardays, <br /> Sundays and legal holidays. <br /> Subd,4. Procedure when data is not accurate or comp!ete. An individual may contest the accuracy orcompte[eness ofpublic orprivate data <br /> conceming himsel£ To exercise this right,an individual shall notify in wiiting the responsible authority describing the nature of[he disagreement.The <br /> resporsible authority shall within 30 days ei[her. (a)con�ect the data found to be inaccurate or incomplete and attemp[to notify past recipients o` <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual hat he helieves the datz to be correct. Da[a in <br /> dispute shall be disclosed onfy if the individual's statement of disagreement is included with che disclosed data. <br /> The de[ermination of che responsible zuthority may be appealed pursuant to thz 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 subj ects of data",we would like to inforn you that your request <br /> for a permit or license from the City of Orono or any oi its departments may require you to furnish certain pnvate or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to deter:nine your qualification for the pemiit or licea�e <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the pe:mit or Iicense. <br /> ti. The infor.nation may be sha:ed with other local, state or federal agencies to the extent necessary to <br /> p:ocess the pernlit or license. <br /> 4. If you��equested permit or license requires Council action to approve; some infomlatior_may become <br /> public. <br /> �. You have certain:ights under M.S. 13.04(available upon request)to:evie��private data on yourself. <br /> 6. I'our full name is required to process this application or permit. <br /> �, � � <br /> �-��-� � � <br /> 'First lti[iddle Last <br /> n <br /> ��U 1 7�� �� �� 11l ✓ ��-.�/�.a� /��� <br /> Address / <br /> ��l�I � � ��,� 2�5-� �/�3�.�� <br /> C�ty State Zip Phone <br /> i understand my rights as stated above. <br /> � /�7 <br /> i�nature.� <br /> 32 <br />