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' � Sec.13.04 RIGHTS OFSUBlECTS OFDATA <br /> Subdivision 1. Type ojdata The rights of irrdividual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Injormation required to be given individuaL An individual asked to supply private or confrdential data concerning himself <br /> shall be informed of.• (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide <br /> system;(6)whether he may refuse or is legally required 10 supply the requested data;(c)a�ry known consequence a�ising from his supplying or <br /> refusing to supplyprivate or confrdential data;and(d)the identity ojother persons or entities authorized by state orfederal law to receive the data. <br /> Thrs requirement shall not apply when an indrvidual is asked to supply imestigatrve data,pursuant to section 13.82, subdivision S,�to a law <br /> enforcement o�cen <br /> The commissioner ofrevenue mav place the notice required under this subdivision in the individual income fax or nropertv tax refund <br /> instructions irrstead of on those forms. <br /> Subd.3.Access to data by indivlduaL Upon request to a responsible authority,an indrvidual shall be informed whether he is the svbject <br /> of stored data on individuals,and whether it is classifred as public,private or confidential. Upon his further request,an indrvidual who is Jhe <br /> subject of stored private or public data on individuals shal!be shown the data without arry charge to him and,if he desrres,shall be informed of <br /> the content and meanrng of that data. After an individua!has been shown the prrvate data and injorneed of its meaning, the data need not be <br /> disclosed to him for six months thereafter unless a dispute or action pursuant to this section is perrding or additiona!data on the individual has <br /> been co/lected or created. The responsible authority shall provide copies of the private or public data upon request by the irrdrvidual subject of <br /> the data. The responsible authority may require the requesting person�o pay the actua/costs of making,cert�ing,and compiling the copres. <br /> The resporrsible authority shall comply rmmedia�ely,if possible,with arry request made pursuant to this subdivrsion,or withrn frve days <br /> of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. l,f he cannot comply wrth the <br /> request wilhin that time,he shall so inform the individual,and may have an additronal frve days wrthin which to comply with the request,excluding <br /> Sahudays,Sundays and legal holidays. , <br /> Subd.4. Procedure when data is not accurate or complete An individual may contest the accuracy or completeness ofpublic or prrvate <br /> data concerning hrmself. To exercise this sight, an rndivrdual shall not�in writing the responsible authorrty describing the nature of the <br /> disagreement. The responsible authority shall within 30 days either: (a)conect the data found to be inaccurate or incomplete and attempt to not� <br /> past recipien�s of irraccurate or incomplete data,rncluding recipients named by the irrdividual;or(6)not�the rndividunl that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is ixcluded with 1he disclosed data. <br /> The determinatron of the respousible authority may be appealed pursuant to the prwisions of the administrative procedure act relating <br /> to contested cases. <br /> DATA PRIVACYADVISORY <br /> In accordance with M.S.13.04,Subd.2,"Rights ofsubjects oJdata';we wou[d like to inform you that your request for apermit orlicense <br /> ,from Jhe City of Orono or any oJits departments may require you to furnish certain private or confidential information. <br /> You are notrfied that: <br /> 1. The information you furnish wrl!be used to determine your qualifrcation for the permit or licerue requested. <br /> 2. You may refuse 10 supply data,but refusal may require that the City de�ry the pernrit or license. <br /> 3. The information may be shared with other local,state or federal agencies to the extent necessary to process 1he permit or <br /> license. <br /> 4. If your requested permit or license requires Counci!action to approve,some rnformation may become public. <br /> 5. You have certain rrghts under M.S.13.04(see following page)to review prrvate data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> PLEASE PRINT <br /> o r�e�- <br /> 'Frrst Middle Last <br /> /aZ.s 5..�, �� � !i� , <br /> Address <br /> �,�ia����a /��/ �,5�3�/ �s.�� 4iZ,s �'p'/� <br /> City State Zip Phone <br /> I u rstand my ri s as stated a ve <br /> ignalure <br /> 10 <br />