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� <br /> Sec.13.0�1 RIGEITS 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 forth in this section. <br /> Subd.2. [nformation required to be given individual. An individual asked to supply private or confidential data conceming himselfshall be <br /> infonned of. (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <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 identity of other persons or entities 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 otticer. <br /> The commissioner of revenue may�lace the notice required under this subdivision in the individual income ta�or propertv taz refund <br /> instructions instead of on those fonns. <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 whed�er it is classitied as public,private or contidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data�vithout any charge to him and,if he desires,shall be informed ofthe content and <br /> meaning of that data. After an individual has been shown die private data and infonned of its meaning,d�e data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this sec[ion is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the pri��ate 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 d�e copies. <br /> The responsible authoriry shall comply immediately,if possibie,with any request made pursuant to this subdivision,or within tive days of <br /> the date ofthe request,exduding 5aturdays,Sundays and legal holidays,if immediate compliance is not possiUle. [fhe cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which[o 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 /> concerning himself. To exercise this right,an individual shall notiFy in writing the responsible authority describing the nature ofthe disagreemenL The <br /> 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 /> inaccurare or incomplete data,induding recipfents named by the individual;or(b)notify the individual that he bel ieves the data to be correct. Da[a in <br /> dispute shail be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating co <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. l 3.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request <br /> for a pennit 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 /> l. The information you furnish will be used to determine your qualification for the permit or license <br /> requested. <br /> ?. 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 permit or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain rigllts under NLS. 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 /> First �liddlc Last <br /> <�^-'V"`C <br /> .4ddre55 <br /> Ciiy Siaii i ip Phone <br /> I underst�'d y rights s st e ove. <br /> �, <br /> Signaturc <br /> Reset Form 3? <br />