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Sec.13.04 RIGI[TS OF SUBJECTS OF DATA <br /> Subd. 1. Typc of data. The rights of individual on whom thc data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required[o be given individual.An individual asked to supply private orconfidential dataconcerning himselfshall be <br /> informed ot: (a)Nte purpose and intended use of thc requested data within thc collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legal ly required to supply thc requested data;(c)any known consequence arising from his supplying or rePusing to supply <br /> private or contidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. "I'his requirement shall <br /> not apply when an individual is ashed to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> 'Che commissioner of revenue may.place the notice required under this subdivision in the individual income tax or propertv tar refund <br /> instructions instead of on those Forms. <br /> Subd.3. Acccss to data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is d�e subjectof <br /> stored data on individuals,and wheNier it is classified as public,private or contidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data widiout any charge to him and,if he desires,shall be informed of the content and <br /> meaning of that data. After an individual has been shown the privale data and infonned of i[s meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant ro this section is pending or additional data on the individual has been collected or created. The <br /> responsible a�thority shall provide copies of the private or public data upon request by tlie 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 possiblc,with any request made pursuant to this subdivision,or within tive days of <br /> the date oY the request,exduding Saturdays,Sundays and legal holidays,if immediatc compliance is not possible. If he ca�mot comply with the request <br /> wifhin that time,he shall so inform Nie individual,and may have an additional Pive days within which to comply with thc request,excluding Saturdays, <br /> 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 private data <br /> concerning himsel£ �Io exercise this right,an individual shall notity in writing the responsible authority describing the nature ofthe disagreemenL The <br /> responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recfpients 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. Data in <br /> dispute shall be disclosed only if the individual's stalement 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 procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADV[SORY <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to infonn 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 /> l. 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 information may be shared with other local, state or federal agencies to the extent necessary to <br /> process the permit or license. <br /> 4. If your rec�uested 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 proc this applicatiott or permit. <br /> s � �— ,�.� � C'o . <br /> First h1iddle Lnst <br /> ����z� �c�-� �l��� <br /> t,�ar�s5 � <br /> �; ��-f�- � (�J ��� 9 SZ . � ��, ���� <br /> c�t,� s�.�r� z�� �no�� <br /> I unde�stand my ights as stated abo e. <br /> � � <br /> Signature <br /> 3� <br />