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, <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA � <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this sectioa <br /> S�bd.2. TntormaHon req�red to be�iven individual. An iffilividual asked ro supply private or confide�ial data concerning himself <br /> shall be informed of: (a)the purpose a4d iabende�i use of the requested data within the wllecting state agency,political subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)any l�own wnsequence arising from his supplying or <br /> refusing to supply private or co�'idential dara;and(�the ide�ity of other peisons or enfldes audiorized by state or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply investigative dara,pursuant to section 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revernie mav nlace dte notice reauired under this subdivision in the individual income tax or nrocertv tax refund <br /> in.cerucdons instead of on those forms. <br /> Subd.3. Access to data by indiridual. Ugon request to a responsible authority,an individual shall be informed whether he is the <br /> svbject of stored data on individuals,and whether it is classified as public,private or confidential. Upon tris further request,an individual who <br /> is the subject of stored private or public data on individuals shall be shown the data without azry charge to him and,if he desires,shall be informed <br /> of the wntent and meaning of tLat data. After an individual has been shown the private data and informed of it�meaning,the data need not be <br /> disclosed to him for six months thereafter unless a dispute or action pursuant to d�is�cdon is pending or addidonal data on the individual has been <br /> collected or created. The responsible authority shall pmvide copies of the priva�or public data upon request by the individual subject of the data. <br /> The responsible authority may require the requesting person to pay the actual costs of malti�►g,certifying,and compiling the copies. <br /> The responst'ble authority shall comply itnmediately,ff possible,with any request made pursuant co this subdivision,or within five days <br /> of the date of the request,excluding Sawrdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with <br /> the request within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request, <br /> excluding Saturdays,Sundays and legal holidays. <br /> Subd.4. Pracedure when data its not accurate or complete. An individual may contest the accuracy or completeness of public or <br /> private data concerning himself. To exerci�this right,an individual shall notify in writing the responsible authority descdbing the nature of the <br /> disagreeme�. The responsible authoriry shall within 30 days eidier. (a)wrrect the data fwnd to be imac�uate or uicomplete and atxempt to notify <br /> past recipie�s of ifficcurate or incomplete data,including recipients named by the individual;or(b)�tify the individual that he believes the data <br /> to be correc� Daha in dispute shall be disclosed only if the individual's so�teme�of disagreement is inciuded with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant w die provisions of the administcative procedure act relaang <br /> to 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 <br /> request for a permit or license from the�ity of Orono or any of its departments may require you to furnish certain ' <br /> private or confidential information. <br /> You aze notified that: <br /> 1. The information you furnish will Ue 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 deny the permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to <br /> precess 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 /> � �i��S-{-i''� �iu-�✓� (` � � ✓'v C-� <br /> First r o Middle L.ast <br /> `�i 2f�.� �"J1 it� ��ri ��a/ <br /> �p�� � o /�,� s',� 3 S-� �l�t � �� 3 c� ( <br /> C�ty State Zip Phone <br /> I understand�ny rights as state a ve. <br /> r <br /> � � � <br /> $lgD'dtUIC <br /> 6 <br />