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,- � . . <br /> � , <br /> r . <br /> • <br /> Sec.13.04 RIGHTS OF S[JBJECTS 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 forth in this section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data concerning himself shall <br /> be informed of: (a)the pucpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supply <br /> private or confidenaal data;and(d)the identity of other persons or enti6es authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigaave data,pursuant to secuon 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav ulace the notice required under this subdivision in the individual income tax or propertv tax refund <br /> inst�ucdons 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 <br /> of stored data on individuals,and whether it is classified as public,private or co�dendal. Upon his further request,an individual who is the subject <br /> of stored piivate or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the content <br /> and meaniag of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for <br /> siz months thereafter unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authority shall provide cop�es of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay,the actual costs of making,certifying, and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date of die request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the roquest <br /> within that time,he,shall so inform the individual,and may have an addirional five days within which to comply with the request,ezcluding 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 notify in writing'the reSpoacible authority describing the nature of the disagreement. <br /> The responsible authoriry 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 individual;or(b)noufy the individual that he believes the data to be cornct. Data <br /> in dispute shall be disclosed only if the individual's sratement of disagreement is included with the disclosed data. <br /> The detecmination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating to <br /> contested cases. , <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.Q4,Subd.2, "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 fumish 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 pemut 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 locai, state or f�deral agencies to the extent necessary to process <br /> the pemut or license. <br /> 4. If your requested pe�mit 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 /> �r��-�-r�-� �'���t� ��.s�,a�-s�,� <br /> First Middle LaSt <br /> l'3 z- ti l Zfd Zp St-l� L,o N <br /> Address <br /> k.�g,�.� �irz-i��� �vr��, �S`�y 6 `�1 Z e --�1 l 7 y. <br /> �i�y State Zip Phone <br /> I understand my 'ghts tate bove. <br /> ✓ Vl� <br /> Signature <br />