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� . . <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 to be stored shall be as set foRh in this section. <br /> Subd.2.Information required to be given individual.An individual asked to supply private or confidenUal data conceming himselfshall be <br /> informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,ar statewide system;(6) <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 idendry of other persons or endties authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement ofticer. <br /> The commissioner of revenue may place the notice reauired under this subdivision in the individual income tax or r�operty tax refund <br /> instructions instead of on those forms. <br /> Subd.3.Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or confidenUal. 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,if he desires,shall he informed of the content and <br /> meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six <br /> mo�ths thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been col►ccted or created. The <br /> responsible authority shall provide copies of the private or public data upon request by the individuai subject of the data. The responsible authority <br /> may require the requesdng person to pay the actual wsts of making,certifying,and compiling the copies. <br /> The responsible authority sha(1 comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional 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 data <br /> conceming himself. To exercise tMs right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The <br /> responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individuel;or(b)notify the individual that he believes the data to be correct.Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination ofthe responsible authority may be appealed pursuant to the provisions ofthe adminisVative 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 pernut or license from the City of Orono or any of its departments may require you to fumish certain private or <br /> confidenrial information. <br /> You are notified that: <br /> 1. T'he information you furnish will be used to determine yow qualificarion 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, state or federal agencies to the extent necessary to <br /> process the permit or license. <br /> 4. If your requested pemvt or license requires Council action to approve, some inforniation 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 fWl name is required to process this applicarion or permit. <br /> ���-,-�.���-� � �r►,.,�- lrl <br /> F�c �aaie Last <br /> � �� s" .S� . 5�1...�,.�..,e�-�.s L�• �� . <br /> Address <br /> 1�'� ' �-n.� s'�-A �'l r� . sS�G � �s"�-y�a - ��� �- <br /> �_�►•�N� <br /> City State Zip Phone <br /> I understand my right stated above. <br /> C <br /> Signatur <br /> � <br /> ' " Reset Form � ��- 32 <br /> {f'�i�rv�;�`" r,�Cs�4��g� <br />