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�. " ,�. � <br /> Sec.l 3.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. I. Type 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. Information required to be given indlvidual. An individual asked to supply private or confidential data concerning himself shall be <br /> iniormed of: (a) the purpose and intended use of the requested data within the collecting state agency, political subdivision, or statewide system; (b) <br /> whether he may refuse or is legally required to supply the requested data; (c) any known consequence arising from his supplying or refusing to supply <br /> private or confidential data; and (d) the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall <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 oi revenue mav place the notice reauired under this subdivision in the individual income tax or oroaertv 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 shall be informed whether he is the subject <br /> of stored data on individuals, and whether it is classified as public, private or confidential. Upon his further request, an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be inFormed of the content and <br /> meaning of that data. ANer 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 authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may <br /> require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the <br /> date of the request, excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possibie. If he cannot comply with the request within <br /> that time, he shall so inform the individual, and may have an additional five days within which to comply with the request, excluding Saturdays, Sundays <br /> 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 notify in writing the responsible authority 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 notify past recipients oi <br /> inaccurate or incomplete data, including recipients named by the individual; or (b) notify the individual that he believes the data to be correct. Data 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 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 (ike 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 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 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 permit or license requires Council action to approve, some information may become 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 /> ��.rT /1�� �h at 1 �ORD��r.� <br /> First Middle Last <br /> �G 1'rJ ��m �Sc�� l-AnJ� <br /> Address <br /> 1-��. 1-�k� M�I/ s.�35� �52-ji�3-8'1�19 <br /> C�tY State Zip Phone <br /> 1 understand my rights as stated above. <br /> �,-�9" <br /> Signature <br />