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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 forth in chis secdon. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data coocerning himself shall <br /> be informed of: (a)the purpose and incended use of the requested data within the collecting'state agency,potiacal subdivision,or sratewide system; <br /> (b}whether he may refuse oY is legally required to supply the requested data;(c)any lrnown consequence arising fmm his supplying or refusing to supply <br /> private or confidenrial data;and(d)the idenciry of other persons or enriaes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investieadve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue mav place the nodce required under this subdivision in the individual income_tax or propertv 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 shail be informed whether he is the subject <br /> of stored data on individuals, and whe[her it is classified as public, private or confidendal. Upon his further request, an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data wichout any charge to him and,�if he desires, shall be informed of the con[ent <br /> and meaning�f chat data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or acrion pursuant to this secaon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesring person to pay the actual costs of making,certifying, and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of <br /> the date of the request,excluding Sacurdays,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 additiona(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 <br /> data conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccurate or incomplete data, including recipients named by che individual;or(b)nodfy the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinaaon of the responsible authoriry may be appealed pu�suant to the provisions of the administrarive 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 furnish 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 permit or license requested. <br /> 2, You may refuse to supply data, but refusal may require that the City deny the pemut or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to process <br /> the pernut or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> g. 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 /> ���w�, .�O �S O N �eD ��� {Ul�(�SC.-t�L- �fz- C7t,J N�� — <br /> First Middle Last <br /> '�� ��; ,.,�� �i , fi7�a�c� <br /> Address �hJ �-L t /„ / Z _��/ ..��--'� <br /> I����7 �� �.f� [ U <br /> Ciry State Zip Phone <br /> I understan my ri t stated above. <br /> Signatu <br />