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. � <br /> Sec.13.04 RIGHTS OF SIJB.TECTS OF DATA <br /> Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set focth in this secdon. <br /> Subd.2. Information reqtrired to be given individual. An individual asked to supply privace or confidenrial data conceming himself shall <br /> be informed of: (a)the purpose and inunded use of the requesred data wichin the collecting'state agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse oY is legaily required to supply the requested data:(c)any laiown consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the idenriry of other persoas or enaries auchorized by state or federal law to receive the data. This requiremenc shall <br /> not apply when an individual is asked to supply invesri¢adve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue mav place the noace reouired under this subdivision in the individual income tax or propertV tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible auchoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as public, private or confidenaal. Upon his further request, an individual who is the subject <br /> of stored private o�public data on individuals shall be shown che data wichout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of[hat data. After an individual has been shown[he private data and informed of its meaning,the dara need not be disclosed to him for <br /> six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authority shall provide copies of the private or public data upon reques[by the individual subject of the data. The responsible authoriry <br /> may require the requesring person to pay the acrual costs of making,cerafying, and compiling the copies. <br /> The responsibie authoriry shail comply immediately, if possible, wich any request made pursuant to this subdivision,or within five days of <br /> the date of che request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is noc possible. If he canaot comply with the request <br /> wi[hin that time,he shall so inform[he individual,and may have an addidonal five days wirhin which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate oc complete. An individual may contest the accuracy or completeness of public or pri��ate <br /> data concerning himseif. To exercise this rieht,an individual shall noafy in wridng the responsible authoriry describing the narure of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, including recipients named by che individual;or(b)nodfy the individual that he believes the data to be correct. Dara <br /> in dispute shall be disc(osed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determina[ion of the responsible au[hority may be appealed pursuant to the provisions of the administradve procedure act relating to <br /> contesred cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Ri�hts of subjects of data", we would like to inform you that your request <br /> for a pernut or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidentiai information. <br /> You are notified that: <br /> 1. The information you furnish wiil be used to determine 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 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 pernut or license. <br /> 4. If your requested 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 process this application or permit. <br /> --T/ <br /> ,�c��j-r •, ` <br /> First ` Mid le Last <br /> /S-�i'� � `�� �-f <br /> Address � �_ , - L . �-� <br /> �� �� �.-� ; j.� /CJ6 �� 1 � ���.�� <br /> City State Zip Phone <br /> / <br /> I understand m� s stat d above. <br /> �' - <br /> � s� .- <br /> Signant <br />