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� � <br /> Sec.13.04 RIGHTS OF SLJBJECTS OF D,�TA <br /> Subd. 1. Type of data. The righcs 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 individual. An individual asked to supply private or co�dendal data conceming himself shall <br /> be informed of: (a)the puipose and intended use of the requested data within the collecdng'stace agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse or is leeally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply <br /> private or confiden[ial data;and(d)the idenary of o[her persons or enaaes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigadve data, pursuan�[o secrion 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the nodce required under this subdivision in the individual income tax or propertv [ax refund <br /> instrucrions 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 whe[her it is classified as public, priva[e or co�dential. Upon his funher 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 of that dara. After 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 thereafrer unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual 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 data. The responsible authoriry <br /> may require the requesting person to pay the actual costs of making, cemfying, 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 Saturdays,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[he individual,and may have an addiaonal five days within which to comply wich the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure rvhen 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 authoriry describing ihe nature of the disagreement. <br /> The responsibte authoriry shall within 30 days either: (a)correcc the data found to be inaccurate or incomplete and attempt to nodfy 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. Data <br /> in dispute shall be disclosed only if the individual's sta[emen[of disagreement is inciuded with the disclosed data. <br /> ITne determination of the responsible authoriry may be appealed pursuant to the provisions of the adaunistradve 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 furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you fumish 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 permit or license. <br /> 4. If your requested pernut 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 /> ,��,'�2.f- ��� �YL'L � <br /> First Middle Las[ <br /> S;�-5 iC��I�I-t�1�.A_ k'L= - <br /> Address <br /> �Glvc� l,-,�f��� Iv�.tv ��'`,��; -�'7C- �.:�lC�i% <br /> �in, State Zip Phone <br /> I under and my rights as stated above. <br /> , ( �-��� �� � �----- - - <br /> �� <br /> Signatu�e' <br />