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, <br /> Scc13A4 RIGHTS OF SUBJECTS OF DATA <br /> Subd. I. Type of data. The rights of individual on�vhom d1e data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Infonnation required to be given individual. Aii individual asked ro supply private or confidential dataconceming himselfshall be <br /> informed of: (a)the purpose and intended use of the requested data witliin the col lecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusin�to supply <br /> private or confidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data. This requirement shal I <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue may_place the notice required under this subdivision in the individual income ta�or orooertv tax refund <br /> instructions insread of on those forms. <br /> Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and�vhether it is classitied as public,private or contidentiaL Upon his further request,an individual�vho is the subject of <br /> stored private or public data on individuals shall be shown[he data�vithout any charge to him and,if he desires,shall be infonned of the content and <br /> meaning of that data. After an individual has been shown the private data and infonned of its meaning,the data need not be disclosed to him tior six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has 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 authority <br /> may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days oP <br /> the date ofthe request,exduding Saturdays,Sundays and legal holidays,ifimmediate compliance is not possible. lfhe cannot comply with the request <br /> within that time,he shall so inform the individual,and ma��have an additional tive days within which to comply with d�e request,e�cluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or canpleteness of public or private data <br /> conceming himself. 'To exercise fhis ri�ht,an individual shall notity in writing the responsible authority describing the nature ofthe disagreement. The <br /> responsible authority shall�vithin 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notif'y 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 correct. Daca in <br /> dispute shall be disclosed only if the individuaPs statement of disagreement is included with the disclosed data. <br /> The detennination ot the responsible authority may be appealed pursuan[to the provisions of the administrative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. I 3.04,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 <br /> requested. <br /> � ,. <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 extenc necessary to <br /> process 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 NI.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 �`liddlc Last <br /> ��/2 ai v� S Tv,l�v �9 <br /> Address <br /> �o,3,�� �a�c.,/�-S i G' /Z l�F� <br /> City �x��-�s lb!�- State �/lJ Z'p !✓' .�,�?3 / Phone �'�"Z ' y�y 2 7�� <br /> I understand my rights as stated above. <br /> Si�n:iture <br /> Reset Form �� <br />