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Sec.13.04 RIGHTS OF SIJBJECTS OF DATA <br /> Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set fonh in this secrion. <br /> Subd.2. Information required to be given individual. �.n individual asked ro supply private or co�dendal data concerning himself shal] <br /> be informed of: (a)the purpose and intended use of the requested data wi[hin the collecting'state agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required[o supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply <br /> priva[e or confidential data;and(d)the idendry of other persons or enddes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrigative data, pursuant to secdon 13.82, subdivision 5, ro a law enforcement o�cer. <br /> The commissioner of revenue mav place the norice required under this subdivision in the individual income tax or provertv tax refund <br /> instrucrions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals, and whether it is classified as public, private or co�dential. Upon his fur[her request, an individual who is the subject <br /> of srored private or public data on individuals shall be shown the data wichout any charge to him and, if he desires, shall be informed of the concent <br /> and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need no[be disclosed to him for <br /> six months thereafter unless a dispute or action pursuant to this secdon is pending o�addidonal data on the individual has been co(lected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible au[horiry <br /> may require the requesting person to pay the actual costs of making, cettifying, and compiling the copies. <br /> The responsible authoriry shali 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 hofidays, if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addidonal five days wi[hin which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure wheu data is not accurate or complete. An individual may contest[he accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shall notify in wri[ing the responsible authoriry describing the nature of the disagreemen[. <br /> The responsible authoriry shall within 30 days either. (a)correcc the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccurate or incomplete data, inc(uding recipiena named by the individual; or(b) notify the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's stacemen�of disagreement is included with the disclosed data. <br /> The detzrminacion of the responsibie authoriry may be appea(ed pursuant to the provisions of the admuustrative 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 /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that che City deny the permit or license. <br /> 3. The information may be shared with other local, state or federal a�encies to the extent necessary to process <br /> the pernut 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 /> First �tiddle Last <br /> Address <br /> Cih, State Zip Phone <br /> I understand my rights as stated above. <br /> Signature <br />