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� <br /> .� <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth in this secaon. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidenaal data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or stacewide <br /> rystem;(b)whether he may refuse or is legally required to suppiy the requested data; (c)any Imown consequence arising from his supplying or <br /> refusing[o supply private or confidendal dara;and(d)the idenary of other persons or endries authorized by sra[e or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply investigadve data, pursuant to section 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenve mav r�lace the nocice reauired under this subdivision in the individual income taz or vrooer[v tax refund <br /> instrucrions instead of on those fortns. <br /> Subd. 3. Access to data by indiridual. Upon request to a responsible authority,an individual shall be informed whether he is the <br /> subject of stored data on individuals, and whether it is classified as public,private or confidenaal. Upon his further request,an individual who <br /> is the subject of stored private or public daa on individuals shall be shown the data without any charge to him and, if he desires,shall be informed <br /> of the content and meaning of that data. Afrer an individual has been shown the private data and informed of iu meaning,the data need not be <br /> disclosed to him for six months thereafrer unless a dispute or action pursuant to this secdon is pending or addinonal data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible au[hority may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any request made pursuant co this subdivision,or within five days <br /> of the dace of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with <br /> the request wichin that cime, 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. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or <br /> private data conceming himself. To exercise this righc, an individual shall nocify in writing the responsible authority describing the nature of the <br /> disagreemenc. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy <br /> past recipients of inaccurate or incomplete dara,including recipients named by the individual;or(b)nodfy the individual that he befieves the data <br /> to be correct. Data in dispute shall be disclosed oniy if the individual's statement of disagreement is included with the disclosed data. <br /> The dererminadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating <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 City of Orono or any of its departments may require you to furnish certain <br /> private or 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 /> 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. <br /> 3. The informa[ion may be shared with other local, state or federal agencies to the extent necessary to <br /> process the pemut 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 appiica[ion or pernut. <br /> ��E �'�- ��c�9s <br /> First Mi e Last <br /> I o�� � . ��w� �--� <br /> Address �/� l��/ G� ` �j3�j q.sZ' /�� � <br /> < �v <br /> C��Y State Zip Phone <br /> I understand my rights as stated a v . <br /> SignaNre <br /> 6 <br />