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w <br /> � <br /> � * , <br /> Sec.13.04 RIGHTS OF SUBJECTS 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 section. <br /> r <br /> Subd.2. Information required to be given individual. An individual asl:ed 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 collectitc�state agency,polltical subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)an��l-nown oonsequence arising from his suppl}•ing or reCusing to supply <br /> private or confidentiat data;and(d)the identity of other persons or entities author¢ed b�state or federa!law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to seaion 1�.82,subdivision 5,to a law enforcement otficer. <br /> The commissioner of revenue mav olace the notice reanired under this sub�ision in the individual income ta�or orooertv tax re[und <br /> instructions mstead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible aQthori2c,an individual shall be informed w hether he is the subject of <br /> stored data on individuals,and whether it is classifed as public,pri�ate or confdential. L-pon his further request,an indi�-idual who is the subject o( <br /> stored private or public data on individuals shall be shown the data without any�cha se tn him and,if he desires,shall be inCormed o[the content and <br /> meaning o(that data. After an individual has been shorvn the pri�ate data and informex�of its meaning,the data need not be disclosed to him for sir <br /> months thereafter unless a dispute or action pursuant to this section is pending or addiUonal data on the individual has been collected or created. The <br /> responsible authority shali provide copies o[the private or public data upon request by the individual subject otthe data. The responsible authority may <br /> require the requesting person to pay the actual costs of making,cemfying,and compilin_t6e copies. <br /> The responsible authority shall comply immediately,if possible,with an.-requtst made pursuant to this subdivision,or within eve days of the <br /> date of the request,ercluding Saturdays,Sundays and legal holida��s i[immediate complixnce is not possible.If he cannot comply with the requestwithin <br /> that time,he shall so inform the individual,and may have an additioual�ve days N ithin w hic6 to comply with the request,e�cluding Saturdays,Sundays <br /> and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An indtvidual ma�-contest the accuracy or completeness of public or private data <br /> concerning himself. To exercise this right,an individual shall notif�in writing the respoan"ble authority describing the nature of the disagreement. The <br /> responsible authority shall within 30 days either: (a)correct the data found to be inan-.nrate or incomplete and attempt to notity past recipients of <br /> inaccurate or incomplete data,including recipients named by the iadividual;or(b)notif�-tLe individual that he believes the data to be correct. Data in <br /> dispute shail be disclosed only if the individual's statement of disatreement is tnclvded rrith the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to che provisions o[the adminlstrati��e procedure act relating to <br /> contested cases. <br /> DATA PRNACY AD�ZSORY <br /> In accordance with NI.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform�-ou that your request <br /> for a permit or license from the City of Orono or an}-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 determine yoar qualification for the permit 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 permit or license. <br /> 4. If your requested permit or license requires Council ac�ion to approve, some information may become <br /> public. <br /> 5. You have certain rights under M.S. 13.0-3(available upon request) to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> � <br /> �� , �•,... <br /> ��a'��(/__ �C,i:o���v l'� <br /> First Middle Last <br /> � ^'� <br /> 1 E�S �-� J�-.��_,� , c:��rl� <br /> Address <br /> ���,�v,l�.� �'�,� S s'o�-�- 61.z ����� j��� <br /> City State Zip Phone <br /> I understand my rights as stated above. , <br /> Signature <br />