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Sec.13.04 RIGHTS OF SUBJECTS OF DaTa <br /> Subd. 1. Type of data. The ri¢hts of individual on whom the data is stored or to be scored shall be as set forth in this secdon. <br /> Subd.2. Information reqirired to be given individual. An individual asked ro supply private or confidenrial data coacemiag himself shall <br /> be informed of: (a)the purpose and in[ended use of the requesred dara within the collecdng"state agency, polidcal subdivision,or sntewide system; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any lmown consequence arising from his supp(ying or refusing to supply <br /> • private or confidenrial data;and(d)che idenriry of other persons or enriaes au[horized by state or federal law to receive che data. This requirement stiall <br /> not apply when an individual is asked to supply invesdearive dara, pursuanc to secdon 13.82, subdivision 5, to a law enforcemenc officer. - <br /> The commissioner of revenuz mav place the noace reauired under this subdivision in the individual income tax or propercv tax refund <br /> instrucdons insczad of on[hose forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsibie auchority,an individual shall be informed whe[her he is the subject <br /> of s�ored data on individuals,and wherher ic is classified as public, privace or confidendal. Upon his fucther request, an individual who is the subject <br /> of stored private or public dara on individuals shall be shown�he data wichout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of�hat data. Afcer an individual has been shown rhe private data and informed of iu meaning, the data need not be disclosed to him for <br /> six mon�hs thereafter uriless a dispute or acrion pursuane to chis secaon is p�nding or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon requesc by the individual subjecc of[he data. The responsible authoriry <br /> may require the requesdng person to pay the actual costs of makine, cerrifying, and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, with any request made pursuant to[his subdivision, or wi[hin five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediace compliance is noc possible. If he cannot comply with the requesc <br /> within that time,he shall so inform[he individual,and may have an addidonal 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 individual may contest the accuracy or completeness of public or pri�•are <br /> data concerning himsetf. To exercise this right,an individual shall noafy in wricing the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days eicher: (a)correct the data found to be inaccurate or incomplete and attempt to noafy past recipienu of <br /> inaccunte or incomplete data, including recipiencs named by rhe individual; or(b)noafy the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's sta[emenc of disagreement is inciuded with the disclosed data. <br /> The decerminaaon of the responsible authoriry may be appealed pursuanc co the provisions of[he adaunisaarive 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 Ciry 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 fumish 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 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 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 /> ._._U�cq�tS �y"I',����� �/� Z Lt✓^,l� <br /> First Middl Last <br /> 11��t`�-5 ��s� ,�v� 1�� <br /> Address � � � n� ��`�7 � L —�%� �� <br /> �i� �v <br /> ���y State Zip Phone <br /> I understand my ri;hts as stated above. <br /> / � � <br /> --- v <br />