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, 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 section. <br /> Subd.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himself shall be <br /> informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whethcr he may refusc or is legally required to supply the requestcd data;(c)any koown consequencc arising from his supplying or rcfusing to supply <br /> private or confidential data;and(d)the identiry of other persons or eotities authorized by state or federal law to receive the data.This requirement shall <br /> not apply when an individual is asked to supply invesdgative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue may nleee the notice reauired under this subdivision in 16e individual income tax or orocertv ta�c refund <br /> instructions instead oFon those forms. <br /> Subd.3.Access to data by individual.Upon request to a responsible authority,an individual shall be informed whetherhe is the subject of <br /> stored data on individuals,and whcther it is classified as public,private or confidentiaL Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without any charge to him and,if he dcsires,s6all be informed of the content aad <br /> meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be discbsed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pcnding or additional data on thc individual 6as been collected or created. The <br /> responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require thc requesting person to pay the actual costs of making,certifying,and compiling thc copies. <br /> The responsible authority 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,ifimmediate compliance is not possible. If he cannot comply with the request <br /> within that timc,he shall so inform the individual,and may have an addidonal five days within which to comply with thc request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete.An individual may contest thc accuracy or completeness of public or private data <br /> concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.The <br /> responsible authoriry shall within 30 days either. (a)corcect the data found to be inaccurate or incomplete and attempt to notify past recipienu of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in <br /> dispute shall be discbsed only if the individual's statement of disagreement is included with the disclosed data. <br /> T6e determination of the responsiblc authority may be appealed pursuant to the provisions of the administrative 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 City of Orono or any of its departments may require you to furnish certain private or <br /> confidenrial information. <br /> You are notified that: <br /> l. The informarion 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 deny the permit or license. <br /> 3. The information may be shared with ather local, state or federal agencies to the extent necessary to <br /> process the percnit or license. <br /> 4. If your requested permit or license requues 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 /> �.�,-�rti c 1� �'ftzS��h {��•VP/I E✓ <br /> First Middle Last <br /> / �P�f�/ 1 � 1 �-✓' ��� ?� <br /> Address C!�� _ <br /> C`�r��..a /I1� S�3� � �i y�/-o�yY <br /> City State Zip Phooe <br /> I understa my rights as stated above. <br /> � <br /> Signature <br /> 32 <br />