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� <br /> Sea 13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The righrs of individual oa whom the data is scored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information reqirired to be given individual. An individual asked to suppiy private or confidendal data concerning himself shall <br /> be informed of: (a)the purpose and incended use of the requesud data within the collecting�ta[c agency,polirical subdivision,or statewide system; <br /> (b)whether he may refuse oY is legally required to supply the requested data:(c)any Irnown consequence arising from his supplying or refusing to supply <br /> privace or confidenrial data;and(d)che idenriry of other penons or enades auchorized by state or federal!aw to receive the data. This requiremenc shall <br /> not apply when an individual is asked to supply invesrigadve data,punuanc to secdon 13.82, subdivision 5, to a taw enforcement officer. <br /> The commissioner of revenue mav place the nodce required under this subdivision in the individual income tax_or oropertv tax rofund <br /> instrucdons instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authariry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whecher it is classified as public,private or confidenaal. Upon his further request,an individual who is the subject <br /> of stored private or public dara on individuals shall be shown rhe data without any charge to him and,-if he desires, shall be informed of the content <br /> and meaning of rhat data. Afrer 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 thereafur unless a dispute or acdon pursuanc co this secaon is pending or addidonal data on the iadividual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the dara. The responsible authority <br /> may require the requesting person to pay the actual cosc�of making,certifying,and compiling the copies. T <br /> The responsible auchoriry shali compiy immediately,if possible,with any requesc made pursuant to this subdivision,or withia five days of <br /> the date of the request,exciuding Saturdays.Sundays and legal holidays,if immediate compliance is not possible. If he canno[comply with die request <br /> within that time,he shall so inform the individuat,and may have an addidonal five days within which to comply with the request,excludiag 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 concerning himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsible au[horiry shall within 30 days either: (a)correcc the data found to be inaccurate or incomplete and aaempc to nodfy past recipienc�of <br /> inaccurate or incomplete data,including recipients named by rhe individual;or(b)noafy the individual that he believes[he data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statemenc of disagreement is included wi[h the disclosed data. <br /> The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the administraave 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 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 aze 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 permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to process <br /> the permit or license. <br /> 4. If your requested pemut 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 /> �,�e Coc,�.r�e.y ��s�-�.�f���rJ <br /> First <br /> Middle �S� <br /> r-�sas �� �r a� <br /> Ad � � (v ��T 7 � —� J ! / <br /> Ciry Smte Zip Phone <br /> I u rstan my rig ated ab ve. <br /> Signature <br />