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Secl3Ad RIGIITS OF SUI3JECTS OF DA'1'A <br /> Subd. I. 7'ype 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. Infonnation req�iired to be givcn individual. An individual asked to supply private or contidential data concerning himself shall be <br /> informed of: (a)the purpose�nd intended use of the requested data within the collecting state agency,pol itical subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)airy known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identit}�of other persons or entities authorized by state or federal law to receive the data. "fhis requirement shal I <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or vropertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individu�l Upon request to a responsible authority,an individual shall be infonned whether he is the subject of <br /> stored d�ta on individuals,and whether it is classified as publiq private or confidential. Upon his further request,an individual who is the subject of <br /> stored privnte or publ ic data on individuals shal I he shown the data without any charge to him and,if he desires,shal I be infonned of the content and <br /> meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authoriry shall provide copies ofthe private or public data upon request by the individual subject of the dat�1. The responsible authority <br /> may require N�e requesting person to pay the actual costs of making,certifying,and compiling the eopies. <br /> The responsible authority shall comply iimnediately,ifpossible,with any requestmade pursu�ntto this subdivision,or within five days of <br /> the date ofthe request,exduding Saturdays,Sundays and legal holidays,if immediate compliancc is not possible. [f he cannotcomply with the request <br /> within that time,he shall so infonn the individual,and tnay have an additional five days within which to comply with the request,excluding Saturdays, <br /> Simdays and legal I�olidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contestthe accurlcy or completeness of public or privnte data <br /> concerning himself. To exercise this right,an individual shall notify in writingthe responsible authority describing the nature ofthe disagreement. 7'he <br /> responsible authority shall within 30 days eitl�er. (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)notify the individual that he believes the data to be correct. Dat�in <br /> dispute shall 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 rellting to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> li�accordance with M.S. 13.04.Subd.2,"Rights of subjects of data",wc would like to inform you that your request <br /> for a permit or liccnse Ii-om Che City�ot�Orono or any of its departments may require you to furnish certain private or <br /> conlidential information. <br /> You are notified that: <br /> l. The information you turnish will be used to determine your qualification for the permit or license <br /> requested. <br /> 2. You may rePuse 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 necessa�y to <br /> process thc permit or license. <br /> 4. If your requested permit or license requires Council action to approve, some inform�tion may become <br /> public. <br /> �. You have certain rights under M.S. ]3.04(available upon request)to review private data on yourself. <br /> 6. Your full i�a�ne is required to process this application or permil. <br /> KD�i�1 �— �} �Kp(a,rl�� <br /> H���sr M�aai� �,as� <br /> o�3oG (��-h �4c��e_ 1?b <br /> Address <br /> ls.� La.�e. M iv �5"3J� 95a-u��-0,05 <br /> Cih� StAte %ip Phonc <br /> [ understand my rights as stated above. <br /> ��;���;��.�.�n <br /> Signature `� <br /> i2 <br />