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� , 1 <br /> ` � <br /> Sec.13.04 RIGHTS OF SLJBJECTS OF DATA <br /> Subd. 1. Type of data. The righrs of individual on whom the data is swred or to be stored shall be as set forth in this section. <br /> Subd.2. InformatIon req�rired to be given individual. An individual asked to supply private or confidential data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data withu►the collecting State agency,poliacal subdivision,or statewide sysum; <br /> (b)whether he may refuse oY is legally required to supply the requemd data;(c)any ffiown consequence arising from his suPP1Y�8 or refusing to supply <br /> private or confidential data;and(d)the idendty of other pecsons or enddes authorized by state or federnl law to receive the data. This nquirement shall <br /> not apply when an individual is asked to supply invesdgadve data,pursuant ro secdon 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav place the noace rewired under this subdivision in the individual income tax or arovem raz refund <br /> insnucdons instead of on those forms. <br /> Subd.3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject <br /> of swred data on individuals,and whe[her it is class�ed as public,private or confidenaal. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuats shall be shown the data without any charge W him and;if he desires,shall be informed of the content <br /> and meaning of that data. Afur an individual has been shown the private data and informed of its meaniag,the data need not be disclosed to him for <br /> six months thereafter unless a dispuu or action pursuant to this section is pending or additional data on the iadividual has been collecud or creaud. <br /> The respoasible authoriry shall provide copies of die private or public data upon request by the imdividual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the.actual costs of making,ceitifying,and compiling the copies. <br /> The responsible authority s6all comply immediately,if possible,with any request made pursuant to this subdivision,or withia five days of <br /> the date of the request,exciuding Saturdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the iadividual,and may have an addiaonal 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 <br /> data conceming himself. To exercise this right,an individual shall norify in wridng the responsible authority describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to noafy past recipienu of <br /> inaccurate or incomplete data,inciuding recipients named by the individual;or(b)notify the individual that he believes the data to be correcc. Data <br /> in dispute shall be disclosed only if the individual's statement of disagmmeat is included with the disclosed data. <br /> The deurminadon of the responsible authoriry may be appealed pursuant W the provisions of the administradve procedure act relating w <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.Z, "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 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 /> (, our full name is required to process this application or permit. <br /> 2..c��- � <br /> First ` Middl�c J`-v`�C`►— �t <br /> � � 3 <br /> Address /f . �/G, 5.��� � / / /"_ 9�� � <br /> � C`.( �f'.�1 v"v ��L'!i <br /> City � Smte Zip Phone <br /> I understand my rights as stated above. <br /> Signaturo <br />