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JUN-28-2006(WED) 09: 08 P. 002/002 <br /> S ce.13.rtd RIGHTS OF SUIErdECM OF DATA <br /> Subd.1. Type of dura. The rights of imlividual on wliom the dap is xorcd or to be stored shall be as set forth in this mcdon. <br /> Subd.Z dnfomwdon requited to be given individual.An individual asked supply private or confidential data concerning himself shall be <br /> informed ol:(a)the purpose and Intended use of flit requested data within the collecting atate agency,political subdivision,orslatewide system;(b) <br /> whether he may refuse or is legally required to supply Ale requested dap;(c)any known consequence arising from his supplying or refusing to supply <br /> private oreonrtdendal data;and(d)the identity of outer persons or entities authorized by state or federal law to receive the data.This tr quirtment shall <br /> not apply when an individual is asked to supply investigative data,pumuitatto section 13.5_',subdivision 5,to a law erdurcoutcnl officer. <br /> T eh,wmmjaalQ0cr Of revenue msv piste the notice mauired under this sukU3dis an Llhrjn4WdNt11. egme tax or prQperpy tax rcfimd <br /> instructions inglyptl,{un those forn", <br /> Subd.3.Access to data by individual.Upon requcsttn a responsible authority,an individual shall be informed whether Ire is Ute subject of <br /> stored dap on individuals,and wbdlwx itis classified as public.private or conrudentdol. Upon his further request,an individual who Is ON subject of <br /> stored private or public data on individuals shall be shown the dam without any charge to him and.If he desirtaa,shall be tnrotmod of the content and <br /> meuming of that tlata.Adler an individual has been shown the private data and informed of its mewing,the data need not be disclosed to him for six <br /> months themafier unless a dispute or action pursuantto this section is pending cr additional data on the Individual has been collected or created.The <br /> responsible authority shall provide copies of pre private or public data upon request by the individual subject of the data.11w responsible authority <br /> may require the requesting person to pay Ae actual costs of making,ecrtifying,and compiling the copies. <br /> Theresponsible authority shall comply immediately,irponible,with any request made pursuant to this subdivision.or wittin five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance Is not posslble.If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional live days within which to comply with the taiquatst,excluding Saturdays, <br /> Sundays and legal holidays. <br /> subd.4.Procedure when data is notacpuatcorcomplem An individual muycontesl theacuxauh urcunipietonep ofpublicorpaivaledap <br /> concerning himself.To exercise this right;an individual shall notify in wrilingthe twponsible uudiority describing IN naturcofthcdisagroomant.The <br /> responsible authority shall within 30 days either: (a)correct the data found to be Inaccurate or incomplete and attempt to notify past recipients of <br /> inuccumia or incoinplctu dap,including recipients named by the individual;or(b)notify die individual Akltlie bel ia vwes the data to be comoa Detain <br /> dispute shall be disclosed only if the individual's statement of disugnzmeal is Included widh pie disclosed data. <br /> The deta r n cation orthc responsible authority may be appeuled pursuant to the provisions of pre administrtttiva procedure actrclatingto <br /> cattasled cases, <br /> DATA PRIVACY ADVISORY <br /> In e=rdancewith M.S.13.04,Subd.2,"Righwofsubjeotsofdata",wewould liketo inform you thatyour 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 /> confitim ial information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City decry the permit or license. <br /> 3. The information may be shared with other local,state or federal agencies to lite extent necessary to <br /> process the permit or Ilcenso. <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 pefmiL <br /> CA U r tn,cy ON <br /> Tint LL Middle last <br /> Addras <br /> 6raAjo AJ G <br /> City Swat 7Ip Phone <br /> I understand my r <br /> • 6-Z8-zoo 6 <br /> Signature <br /> gl. s, 32 <br />