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� <br /> � � <br /> � � , <br /> . <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The righa of individual on whom the data is stored or to be scored shall be as set focth in this secdon. <br /> Subd.2. Iaformation reqirired to be given individual. An individual asked to supply private or confidenriai data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requesud data within the collecting§tate agency,polidcal subdivision,or sracewide system; <br /> (b)whether he may refuse o'r is legally required to supply the requested data;(c)any Irnown consequence arisiag from tus supplying or refusing to supply <br /> private or confidential data;and(d)the idenriry of ocher persons or endaes au[horized by state or federal law to receive the data. 'This requirement shall <br /> not apply when an individual is asked to supply investigadve dara,pursuant to section 13.82, subdivision 5,to a law enforcement o�cer. <br /> The commissioner of revenue mav place the noace required under this subdivision in the individual income rax or propertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of scored data on individuals,and whe�her it is classified as public, private or confidendal. Upon his further request,aa individual who is the subjecc <br /> of stored private or public dara on individuals shall be shown che darn wi[hout any charge to him and,if he desires,shall be informed of the content <br /> and meaning of that data. After an individual has been shown the private dara and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or acaon pursuant to[his secdon is pending or addidonal dara on the individual has been collected or created. <br /> The rosponsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actuai cosu of making,cerdfying,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,exctuding Samrdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannoc comply with the request <br /> within that time,he shall so inform the individual,and may have an addidonal five days within wtuch to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or completeness of public or private <br /> � data conceming himself. To exercise this right,an individual shall nodfy in writing the rosponsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiete and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data,including recipients named by[he individual;or(b)notify the individual that he believes the data to be cocrect. Data <br /> in dispute shail be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. <br /> The determinadon of the responsible authority may be appealed pursuant to the provisions of the adminisaadve 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 Ciry 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 detemune 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 eztent 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 <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 /> uE-�VD <br /> irst Middle �S� <br /> .��.��1� �A� 2.�._ R,�._�O, - <br /> Address �D �nA �l ���C� q y�9 3��5 <br /> M�a-P�-r U�-:r� � l�(N ►�� . <br /> Ciry Sm� Zip Phone <br /> I understand my ri hts as stated above. <br /> S► nature <br />