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Sec.13.04 RIGHTS OF SLIBJECTS OF DaT� <br /> Subd. 1. Type of data. The righcs of individual on whom che data is stored or to be scored shall be as set for[h in this secrion. <br /> Subd.'_'. Information required to be given indiridual. An individuai asked to supply private or confidential data concerning hicnself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, policical subdivision,or statewide system; <br /> (b)whether he may refuse oY is legally required to supply the requested data:(c)any Imown consequence arising from his supplying or refusing to suppty <br /> privace or confidential data;and(d)rhe iden�ity of other perso�s or enrides auchorized by state or federai law to receive the data. This requiremenc shall <br /> not apply when an individual is asked to supply invesdeaave dara, pursuant to section 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue mav plac the norice reauired under this subdivision in the individual income_tax or propercv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by indi�idual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of scored data on individuals, and whether it is classified as public, priva[e or confidendal. Upon his further request, an individual who is the subject <br /> of stored private or public data on individuals shall be shown[he data without any charge to hun and, if he desires, shall be informed of the content <br /> and meaning of that data. After an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or acrion pursuanc to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shali provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesring person to pay the actual costs of making, certifying;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 noc possible. If he cannot comp(y with the request <br /> within that time,he shall so inforrtt[he individual,and may have an additional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individua(may contest the accuracy or completeness of public or pri�•ate <br /> data concerning himself. To exercise this rieht,an individual shall nocify in wridng the responsible authority describing[he nature of the disagreement. <br /> The responsible authoriry shall within 30 days ei[her. (a)correct 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 corcect. Data <br /> in dispu[e shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. <br /> The determination of the rosponsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladne to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Ri�h[s 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 deparcments may require you to fumish 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 pemut 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 shazed with other local, state or federal agencies to the extent necessary to process <br /> the pernut or license. � <br /> 4. If your requested permic or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. <br /> (. Your full name is required to process this application or permit. <br /> �–i��C j� y �.,�� f�C t �,L i 7�– � � -;'�n c'�„�� �� <br /> First yfiddle Last <br /> Z-L-I ( �' 1��c�.c.� 1 �—' I� I <br /> � <br /> Address "\ —r_ _ � � `"`�;, � / 1 �% � �I C��.�C� <br /> C ��� �, �L � '�'�_l � �'"��� � � 1 .� � � � <br /> �iry State Zip Phone <br /> I understand my rights as stated above. <br /> C _ _� ,.�/ . —. <br /> �_�/ F ( yl/�'C� �t.�!' � i <br /> ..Sign�–r�---- <br />