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r . , <br /> Sec.13.04 RIGHTS OF SUBJECTS OF D�T�1 <br /> Subd. 1. Type of data. The rieh[s of individual on whom the data is stored or to be stored shall be as set forth in this secaon. <br /> Subd. '_'. Iaformation required to be��en indicidual. �n individual asked co suop(y private or conndeaaal data conceming himself shall <br /> be informed of: (a) [he purpose and intended use of[he requested dara wi[hin the collecting'state agency, polidcal subdivisioo, or stacewide system; <br /> (b)whecher he may refuse or is le2ally required to suoply�he requested dara;(c)any�own consequence arising from his supplying or refusing ro supply <br /> priva[e or confidendal dara;and(d)the identi[y of orher persons or enades authorized by state or fzderal law to receive the data. This requirement shall <br /> not apply when an individual is asked ro supply invesdganve data, pursuant to secdon 13.82, subdivision�, ro a law en2orcement o�cer. <br /> The comm ssioner of re�e ue mav eiace tne nodc r auired under this subdivision in the individual income tax or oropem t�_refund <br /> ins[rucrions ins[ead oi on rhose iorms. <br /> Subd. 3. Access to data by individual. L'pon request to a responsible auchority,an individual shall be inYormed whecher he is the subjec[ <br /> of stored data on individuals, and whe�her i[is classuied as public, pnva[e or contidenaal. lipon his further reques[, an individual who is the subject <br /> of stored private or public data on individuals shall be shown[he da�a wiehou[any charge ro him and, if he desires, shall be informed of the content <br /> and meaning of that data. Afrec an individual has been shown�he priva�e data and informed of its meaning, the data need not be disclosed to him for <br /> six months thereatter unless a dispuce or acaon pursuanc to �his secaon is pending or addiao�al data on[he individual has been collected or crea�ed. <br /> The responsible authoriry shall provide copizs of ehe pri�•ate or puolic data upon request by[he individual subject of the data. The responsible authoriry <br /> may require the requesring person ro pay �he actual costs of making, cerrifyine, and compiling[he copies. <br /> The responsible authoriry shall compiy immediacely, if possible, wich any request made pursuant to this subdivision, or wi[hin five days of <br /> the date of the request,excluding 5a[urdays.3undays and leeal holidays, if immediate compliance is no[possible. If he cannot compty with the request <br /> within that time, he shall so iniorm the individual,and may have an addidonal five days wichin which to comply with rhe request,excluding Sa[urdays, <br /> Sundays and legal holidays. <br /> Subd.d. Procedure when data is not accurate or complete. An individual may contest[he accuracy or compleceness of public or priva[e <br /> data concerning himself. To exercise[his rieht,an individual shall no�ify in wricing[he responsible au�horicy describing the nature of the disagreement. <br /> The responsible au[horiry shall within 30 days either. (a)correct the data found to be inaccurace or incomplete and attempt to nonfy past recipienes of <br /> inaccurate or incomp(ete data, includine recipien[s named by [he individual; or(b) nodty the individual rha[he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's sta�emer.c of disaereement is included with the disclosed data. <br /> The determination of the responsible aucnori[y may be appealed pursuan�ro �he prov�sions of the admuusaative procedure acc rela[ine to <br /> conces[ed cases. <br /> DAT:� PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. �', "Ri�hts of subjects of data", we wouid like to inform you that your request <br /> for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or <br /> confidential information. <br /> `�'ou wz notiited tl,,at: <br /> 1. The information you fumish will be used to determine your qualification for the permit or license requested. <br /> 2 You may refuse ro supply dara, but refusal may require that the City deny the permit or license. <br /> 3. The information may be shared with other local, s[ate or federal aaencies to the extent necessary 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 /> 5, You have certain rights under 'vf.S. 13.04 (available uoon request) to review private data on yourself. <br /> (. Your full name is required to process this application or permit. <br /> � _ <br /> y � <br /> �� � �; �� � r ' �, <br /> First ltiddle Last <br /> / _ / i � � �`\ <br /> � � L <br /> Address � <br /> � / ( , , �; <br /> � i`� ;. � � � � <br /> Ciry State Zip Phone <br /> I underst� my rights as sta�ed above. <br /> f <br /> , � _ _ <br /> Signature <br />