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� <br /> . <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The righrs 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 conceming himself shall <br /> be infocmed of: (a)the purpose and intended use of the requested data wi[hin the collecting'state agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse or is leeally required to supply the requested data;(c)any Imown consequence arising fmm his supplying or refusing to supply <br /> priva[e or confidendal data;and(d)che idendry of other persoc�s or enddes authorized by state or fedecal law ro receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrigaave data, pursuant to secaon 13.82, subdivision 5, to a law enforcemen[officer. <br /> The commissioner of revenue mav place the nodce required under this subdivision in the individual income [ax or propem tax refund <br /> instrucrions instead of on[hose forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whecher he is the subject <br /> of stored data on individuals, and whe[her it is classified as public, priva�e or confidential. Upon his further requesc, an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the content <br /> and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or creaced. <br /> The responsible auchoriry shall provide copies of the private or public data upon reques[by the individual subject of che data. The responsible auchoriry <br /> may require the requesting person to pay the actual costs of making, certifying, and compiling the copies. <br /> The responsible au[hority 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 immediare compliance is no[possible. If he cannot comply with the request <br /> within that time,he shail so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Sarurdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accu:ate or complete. An individual may contesc the accuracy or completeness of pubfic oc private <br /> data conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shall wichin 30 days either: (a)correc[rhe data found to be inaccurate or incomplete and attempt to noafy past recipients of <br /> inaccurate or incomplete data, including recipienu named by the individual; or(b)notify the individual that he believes the data to be correct. Data <br /> in dispute shal(be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The de[ermination of the responsibfe authority may be appealed pursuant to the provisions of the administradve procedure act relating 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 permit 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 fumish will be used to deternune 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 pernut 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 pernut or license requires Council action to approve, some information may become <br /> public. <br /> j. 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 /> '1�h� rh a.S �S G� �(/�{'�e c�� l� <br /> F sc <br /> � iddle Las[ <br /> �(� � C� 1�b v� � �ev r /�E �+�'� <br /> Addre/ss /� �� ��l ��1 �5 � � � � 7 � ��3� <br /> �/v <br /> Ciry State Zip Phone <br /> I understand my'rights as stated above. <br /> Signanire <br />