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Sec.13.0�! RIGHTSOFSUBJECTSOFDATA <br /> Subdivision 1. Type of data. The rights of individua!on whom the data is stored or to be stored shall be as set forth in thrs section. <br /> Subd.2. Injormation requi�ed to be given individuaL An individual asked to supply private or confidential data concerning himself <br /> shall be informed of.� (aJ the purpose and intended use of the reguested data within the collecting state agency,politrcal subdrvision,or statex•ide <br /> system;(6)whether he may refuse or rs legally required to supply the requested data;(c)any known consequence arising from his supplying or <br /> refusing to supply private or confidential data;and(d)the rdentrry of other persons or entrties authorized by state or federal lmv to receive the data. <br /> This requirement shall not apply ia�hen an individua!is asked to supply investigative data,pursuant to sectron 13.82, s:�bdrvision S, to a!mv <br /> enforcement o�cer. <br /> The commissioner oI revenue may place the notice requrred under this subdivision in the individttal income tax or properry tax refund <br /> instructions instead af on those(orms. <br /> Subd.3. Access to data 6y individual. Upon request to a responsrble authoriry,an individual shall be rnformed whether he is the s:�bject <br /> of stored data on rndividuals,and whether it rs classified as public,private or confrdential. Upon his further request,an rndividua!who rs the <br /> subject oJstored private or public data on individuals shall be shown the data without any charge to him and, if he desires,shall be informed of <br /> the content and meaning of that data. After an individual has been shotivn the private data and informed of its meaning, the data need not be <br /> disclosed 10 him for six months thereafter unless a dispute or actron pursuant to this section is pendrng or additiona!data on the individual has <br /> been collected or created. The responsible authoriry shall provide copies of the prrvate or public data upon request by the individual subject of <br /> the data. The responsible authority may require the requestrng person to pay the actual costs of making,cert�ing,and compiling the copres. <br /> The responsible authority shall comply immedrately,rfpossib(e,with any request made pursuant to this subdivisron,or tivithin five days <br /> of the date of the request,ezcluding Saturdays,S:�ndays and legal holidays,ijimmediate compliance is not possible. If he cannot comply with the <br /> request within that time,he shall so inform the individual,and may have an addrtional five days tivithin ivhich to comply ivith the request,excluding <br /> Saturdays,Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete.An individual may contest the accuracy or compleleness ofp:�blrc or prn•a�e <br /> data concerning himse[f. To exercise this righf, an individual shall notify in wriling the responsible authorrty describing the nature of the <br /> disagreement. The responsible authoriry shall within 30 days either: (a)correct the data fotrnd to be rnaccurate or incomplete and attempt to norify <br /> past reciprents of inaccurate or incomplete data,including reciprents named by the indivrdual;or(b)notrfy the rndividual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination oJthe responsible authority may be appealed pursuant to the provisions oJthe adminisJrative procedure act relating <br /> to contested cases. <br /> DATA PRIVACYADVISORY <br /> In accordance with M.S.13.04,Subd.2, "Rights ofsubjects ofdata';we tivouldlike to rnformyoi�thatyour requestfor apermit or license <br /> from the Crty of Orono or any ojits departments may require you to furnrsh certain private or confdential information. <br /> You are nottfted that.• <br /> 1. The information you furnish will be used Jo determine your qualificatron for the permit or license requested. <br /> 2. You may refuse to supply data,bul refusal may require that the City deny the permit or license. <br /> 3. The information may be shared with other/ocal,state or jederal agencies to the extent necessary to process the permit or <br /> license. <br /> 4. Ijyour requested permrt or license requires Counci!action to approve,some information may become publrc. <br /> 5. You have certain rights under M.S. 13.04(see jollowing page)to review prrvate data on yourselj. <br /> 6. Your ful!name is reguired to process this application or permrt. <br /> PLEASE PRINT <br /> �/d.� � �✓�l�/G�e�-3'L <br /> First Middle Last <br /> Address <br /> City State Zip Phone <br /> !understand my rrghts as stated above <br /> Signature <br /> /0 <br />