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r f <br /> Sec.13.04 RIGHTS OF SUBJECTS OF D?►T.+i <br /> Subd. 1. Type of data. The righcs of individual on whom che data is stor�or to be stomd shall be as set for[h in this secaon. <br /> Subd.2. Information reqirired to be givm indiridual. .1n ir.dividua!asked to supply private or confidenrial data concerning himself shall <br /> be informed of: (a)[he purpose and iacended use of the enquested data wi3un the collecang State agency,polidcal subdivision,or sracewide sysum; <br /> (b)wheet►er he may refuse oY is legally requicod to supply ehe requessed dats:(c)any l�own consequence arising from his supplying or refusing to supply <br /> privace or confidenriai daa;and(d)the idenriry of other persons or enddes auchorized by srate or federal law to receive the data..This requiremenc shall <br /> not apply whan an individuai is asked to supply invesdgaave data,pursuaar to secaon 13.82,subdivision S,co a law enforcement o�cer. <br /> 'ihe commissioner of re�enue r�av place the noace reauired ender this subdivision in the individual income_tax_or prooern tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by indi.idual. Upon requesc to a resgonsible aa�hority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whe�her it is class�ed as public,priva�or con6denrial. Upon his further requesc,an individual wha is the subject <br /> of scored private or pubiic data on individuals shall be shown che dara wi�:out any c'aarge to him and,-if he desires,shall be informed of the concenc <br /> and meaning of chat data. Aftec an individual has been shown che priva::dan and iaiormed of its meaning,the dara need not be disclosed to him for <br /> six monrhs chereaiter unless a dispute or acdon pursuan�to ehis secdon is y:nding or addidooal data on the individual has been collected or creaced. <br /> The responsible auchoriry shall provide copies of the private or public data Lron requ:s:by the individual subject of[he daca. The responsible au[horiry <br /> may require che requesting person to pay[he actual cosu of makin¢,cerying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possibi=,wich any r_quest made pursuant to this subdivision,or wi[hin five days of <br /> the date of the request,excluding Saardays,Sundays and legal holidays,if imrnediace compliance is not possible. If he cannot comply with the request <br /> wi[hin�hac time,he shall so inform the individual,and may have an addidoaal five days wiehin which to comply wich ehe request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data Ls not accurate or complete. An individual may conust the accuracy or completeness of pubiic or pri�•ate <br /> dars conceming himself. To exercise chis righ4 an individual shall nodfy ia wridng r�e responsible authoriry describing che nacure of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data fcund to be inaccucaee or incomplete and aaempt to nodfy past ncipienu of <br /> inaccurace or incomplete data, including recipienes named by che individi:al:or(b)eodfy the individual thac he believes the data to be cocrecc. Dara <br /> in dispu�e shall be disciosed only if the individual's stacemenc of disagr:c�ent is ir.cl•ided with[he disclosed dara. <br /> The de�erminadon of the responsible aurhoriry may be appeal:3 pursuac�to the provisions of ehe adminisaarive procedure act relating to <br /> concested cases. . <br /> DATA PRIVaCY ADVISORY <br /> In accordance with M.S. 13.04,Subd.2, "Rights of subjects oi data", we would like to inform you that your request <br /> for a permit or license from the Ciry of Orono or any of i�s deparments may require you to fumish certain privace or <br /> confidential information. <br /> You are notified that: <br /> 1, The information you furnish will be used to de;ermine}•our qualification for the permit or license requested. <br /> 2. You may refuse to supply data, buc refusal may require that the City deny the permit or license. <br /> 3, The information may be shared with ocher loc�l, state or federal agencies to the extenc neeessary 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 /> �. You have certain rights under M.S. 13.04 (available upon requestj to review private data on yourself. <br /> 6. Your full name is required to process this aoplica[ion or permit. <br /> l��i✓ � �oZ/�Gi��/" <br /> First �tiddie Lasc <br /> 1�aG s���� ��G�` ,�� <br /> Addres �JVI 0 �� ��J�� ��02 ".����.3� <br /> Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> �-. <br /> Signamro <br />