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�! <br /> Sec.13.04 RIGATS OF S[JBJECTS OF DATA <br /> Subd. 1. Type of data. The rights 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 indivfduai, pa indi�idual asked ro supply private or confidenda!data conceming himself , <br /> shall be informed of: (a)che purpose and intended use of the requested data within the collecdng state agency,po(idcai subdivision,or statewide <br /> rys�em;(b)whether he may refuse or is legally required to suppIy the requesud dara;(c)any Imown consequence arising from his supplying or <br /> refusing ro supply priva[e or confidrndal data;and(d)the idenriry of othec persons or enuties autharized by sate or federal law to receive che data. <br /> This requirement shall noc apply when an individual is azked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law <br /> enforeement officer. <br /> The commissioner of revernte mav otace the notice rcwired under this subdivision in the individual income tax or or em tax refund <br /> ir�cnurions mscead of on rhose fortns. <br /> Subd. 3. Access to data by iadividual. Upon request to a responsible authoriry,an individual shail be informed whether he is the <br /> subject of scored data on individuals,and wherher it is c(assified as public,private or con6denrial. Upon his further request,an individual who <br /> is the subject of stored privare or public data on individuals sha11 be shown the data wirhout any charge to him and,if he desires,shall be infocmed <br /> of the con�ent and meaning of that dara. After an individual has been shown the private data and informed of its meaning,rhe data need not be <br /> disciosed w him for six months thereaftec unless a dispuu or acdon pursuant ro dus section is pending or addiriona!data on the individuai has been <br /> collected or created. The responsible authoriry shall provide copies of the private or public dara upon request by the individual subject of the data. <br /> The respoasible authority may require the requesring person to pay the actval cosu of making,certifying,and compiling the copies. <br /> Tha responsibte authoriry shall compty immediately,if possible,wi[h any request made pursuanc to this subdivision,or wichin five days <br /> of the dace of rhe request,ezcluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with <br /> che requen wirhin that time, he shall so inform the individual,and may have an addidonal five days wirhin which to comply with the request, <br /> cxctuding Saturdays,Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or comp(eteness of public or <br /> priva[e daca concerting himself. To eaercise this right,an individuai shall notify in writing the responsible authority describing the nature of the <br /> disagreemen� The responsible authoriry shall within 30 days ei[her: (a)correct the data found to be inaccurate or incomplete and attempt to notify <br /> past migiena of inaccura[e or iiuomple�e dard,inc(uding recipients named by the individual;or(b)noafy the individual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of rhe adminisu�aave procedure act relaring <br /> to contes[ed 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 �ity of Orono or any of iu departments may require you to furnish certain <br /> private or confidential information. <br /> You are notified thar. <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 requ'ue that the Ciry deny the permit or license. <br /> 3. The information may be shared with other local, s[ate or federal agencies to the extent necessary to <br /> process the permit or license. <br /> 4. If your requested pemut or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain ria�hts 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 /> Firs`=''1�i� �� � � �G� <br /> M�ddle �S� <br /> ���� �QC � �/l�� <br /> ?.ddres�n� � A^� <br /> Y V Iwt, �� I �2. ��—'��p1� <br /> Ciry 3tace Zip � Phone <br /> I understand my rights as stated above. <br /> � <br /> SignaNre <br /> � <br />