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3ec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> , <br /> Subd.L Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. , <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be <br /> informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is Icgally required to supply the requested data;(c)any knorvn consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity oCother persons or entities authorized by state or federal law to receive the data. This requirement shall <br /> not appty 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 tnav place the notice required under this subdivision in the individual income taz or oronerfY tax re(und <br /> instructions instcad of on those fonns. <br /> Subd.3. Access to data by�ndividuaL Upon request to a responsible authority,an individual shall be informed whethen c�is the subject of <br /> stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be sho�vn the data without any charge to him and,if he desires,shall be i�formed of the content and <br /> �neaning of that data. After an individual has becn shown thc private data and informed of its mcaning,the data need not be disclosed to I�im for six <br /> months thercafter 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 requcst by the individual subject of the data. The responsible autliority may <br /> requirc the requesting person to pay the actual costs of malcing,certifying,and compiling the copies. <br /> The responsiblc authority shall comply immediatcly,if possible,with any requcst made pursuant to this subdivision,or within eve days of the <br /> date of thc request,excluding Saturdays,Sundays and legal holidays,if immediate compliancc is not possible.If he cannot comply with thc request within <br /> that time,hc shall so inform the individual,and may 6avc an additional Gvc days within which to comply with the request,cxcluding Saturdays,Su��days <br /> and Icgal holidays. <br /> Subd.4. Proccdure when data is not accurate or co�nplete. An individual may contest H�e accuracy or completeness of public or private data <br /> concerning himself. To exercise this right,an individual shall notify in writing the responsible authm•ity describing the nature of the disagreement. The <br /> responsible authority sha►1 within 30 days eithe�: (a)correct the data found to be inaccurate or incompletc and attempt to notiCy past rccipients of <br /> inaccurate or incomplete data,including recipie��ts named by the individual;or(b)noti(y the individual that he bclicves the data lo be correcL Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedw�e act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance�vith 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 deternune your qualification for tl�e pernut 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 /> ✓��. � �r�.�,� ��� ��� ,�. <br /> First Middle �� Last <br /> � �:�� �5 l���-/'YI/��2� <br /> :�Cddress <br /> C� �v�U �2�f2/ 5��3.�/ �����-��9s <br /> City State Zip Phone � <br /> I understand my rights as stated above. <br /> � - <br /> Signature <br /> � <br />