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Sec.13.04 RIGHTS OF SUBJECTS OF D�TA <br /> Subd. 1. Type of data. The righcs of individual on whom[he data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidenaal data conceming himself shall <br /> be informed of: (a)the purpose and intended use of the requested dara within the colleccing"state agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse ot is legally required to suppiy the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidenoal data;and(d)the idenriry of other persons or endaes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to suppiy invesrigarive dara,pursuant to section 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of revenue mav place the noace reauired under this subdivision in the individual income tax oc propertv tax refund <br /> instructions instead 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 <br /> of stored data on individuals,and whether it is classified as public, private or confidendal. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data without any charge to hun and, if he desires, shall be informed of the con[ent <br /> and meaning of that data. Afrzr an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to him for <br /> six months thereafre�unless a dispute or acrion pursuant to this secdon is pending or addidonal data on the individual has been coilected or created. <br /> The responsible auchoriry shail provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the actual costs of making, certifying,and compiling the copies. <br /> The responsible auchoriry 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,if immediate compliance is no[possible. If he cannot compiy with the request <br /> within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legai holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private <br /> data conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing�he nature of the disagreemeot. <br /> The responsible authoriry shall within 30 days ei[her: (a)correct the data found to be inaccunte or incomplete and attempt to nodfy past recipients of <br /> inaccurate or incomplete data, including recipients named by tbe 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 statement of disagreement is included with the disclosed data. <br /> The de[ermination of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act rela[ing 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 pernut or license from the City of Orono or any of its departments may require you to fumish 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 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 /> First Middle Last <br /> Address <br /> Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> � <br /> / � ,�/��� <br /> :�i1�lu l� /L—2—'�'L�G <br /> Signature <br />