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Sec.13.04 RIGHTS OF SUBJECTS OF DATA <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 orconfidential data conceming himselfshal!be <br /> informed of. (a)the purpose and intended use of the reques[ed data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to suppiy <br /> private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shal I <br /> not apply when an individual is asked to supply investi�ative data,pursuant to section 13.82,subdivision�,to a law enforcemenToffice� <br /> The commissioner of revenue mayplace the notice rec�red wlder this subdivision in the individual income�-er orooertv tax refund <br /> instructions instead of on those fonns. <br /> Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be infonned whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or confidentiai. Upon his further request,an individual who is the subject of <br /> stored private or public data on i��dividuals shall be shown the dafa without any charge to him and,if he desires,shall be informed ofthe content and <br /> 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 six <br /> months thereatter 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 request by the individual subjec[ofthe data. The responsible authoriN <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 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 not possible. Ifhe cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional tive days within which to comply wi[h the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure�vhen data is not accurate or complete. An individual may contest the accuracy or completeness ol publ ic or private data <br /> conceming himself. To ecercise Ihis right,an individuaf shall notify in�vriting the responsible authoriry describing the nature ofthe disagreement. The <br /> responsible authority shall within 30 days either (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by die 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 statement of disagreement is included with the disclosed data. <br /> The determination of[he responsible authority may be appealed pursuant to the provisions of d�e administrative 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 infortn you that your request <br /> for a pern�it or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential infor►nation. <br /> You are notified that: <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 rePusal 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 requested permit or license requires Council action to approve, some information may becorne <br /> public. <br /> 5. You have certain rights under NLS. 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 /> �/�l f� r�. r� L r' r � )�, ��'� <br /> First �tiddle Last <br /> �o�s .�_ S� v w-r� �.,�5 l�l� � l/..�" ;2, � <br /> Address <br /> I/Yl I ` r��v��'�- ,.� � (�l ti sS s� L/ �s �-�!��-G�:��. <br /> Citv State Zip Phonc <br /> I understand my ri s as s t d a ve. <br /> ��. <br /> Signaturc <br /> Reset Form �=' <br />