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f � <br /> � . <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or co be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself <br /> shall be informed of: (a)the purpose and inte�ed use of the requested data within[he collecring state agency,polirical svbdivision,or statewide <br /> system;(b)whether he may refuse or is legally required ro supply the requested data;(c)aay lrnown consequence arising from his supplying or <br /> refusing ro supply private or confidential data;and(d)the identiry of other persons er endties auihorized by state or federal law ro receive the data. <br /> This requirement shall not apply when an individual is asked to suppiy invesrigaave data, pursuant to section 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav�lace the notice reauired under this subdivision in the individual income tax or orocertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsir::authorin�,an individual shall be informed whether he is the <br /> subject of stored data on individuals,and whether it is classified as public,priva::or confidential. Upon his further request,an individual who <br /> is the subject of stored private or public data on individuals shall be shown the dara uithout am•charge to him and,if he desires,shall be informed <br /> of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six months thereafter unless a dispute or acdon pursuant to this xction is pe�ing or addidonal data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the privace e-public dara upon request by the individual subject of the data. <br /> The responsible authoriry may require the requesring person to pay the actual co�of maldng,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with a� request made pursuant to this subdivision,or within five days <br /> of the date of the request,excluding Saturdays,Sundays and legal hotidays,if i�mediate compliance is not possible. If he cannot comply with <br /> the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request, <br /> ezcluding Saturdays,Su�ays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An in,:ividual may contest the accuracy or completeness of public or <br /> private data conceming himself. To exercise tftis right,an individual shall notif��in writing[he responsible authority describing the t�ature of the <br /> disagreement. The responsible suthoriry shall within 30 days either. (a)correct th:data fou�ro be inaccurate or incomplete and attempt to notify <br /> past recipients of inaccurate or incomplete data,ic�cluding recipients named by tht iadividual:or(b)notify the individual that he believes the data <br /> to be correct. Data in dispuu shall be disclosed only if the individual's statemera of disaQreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursu�.-t to the pro��isions of the administrative procedure act relating <br /> to contested cases. <br /> DATA PRIVACY AD�TSORY <br /> In accordance with M.S. 13.04, Subd. 2, "Rights of subjec�s of data", we would like to inform you that your <br /> request for a permit or license from the �ity of Orono or any of its depar�ments may require you to furnish certain <br /> private or confidential information. <br /> You are notified that: <br /> 1. The information you fiimish will be used to determine }�our qualification for the permit or license <br /> 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, scate or federal agencies to the extent necessary to <br /> process 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 /> ��l ,��e...� �o � h <br /> First Middle Last <br /> a�, �j ��'��� ���� ,1 �, <br /> Address <br /> ,��c�r�� �i� .��3!�/ 9���7�-£�7;� <br /> Ciry Sta� Zip Phone <br /> I understand my rights as stated above. <br /> S mre <br /> 6 <br />