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• . � . � , s � • <br /> Sec.13.0a RIGEITS O�SUBJECTS OF Dr�TA <br /> Subd. L Type of data. The rights oti individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Infonnation required ro be given individual. An individual asked to supply private or confidential dataconcerning himselfshall be <br /> informed of. (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether lte may refuse or is legal ly required to supply the requested data;(c)any known consequence arising Yrom his supplying or refusing to supply <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 shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The comtnissioner of revenue may place the notice required under this subdivision in the individual income tax or pro�erty tax refund <br /> insVuctions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is che subject of <br /> stored data on individuals,and whether it is classitied as pubiic,private or confidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the dafa without any charge to him and,if he desires,shall be informed ofthe content and <br /> meailing of that data. After an individual has been sho�vn the private data and infonned of its meaning,the data need not be disclosed to Itim for siz <br /> months thereafter 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 subject of the daca. The responsible authority <br /> may require the requesting person to pay the actual costs of making,certifying,and compilin�the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of <br /> the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [fhe cannot comply with the request <br /> �vithin that time,he shall so inform the individual,and may have an additional tive days within which to comply with the request,e�cl uding 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 /> conceming Itimself. To esercise this right,an individual shall notify in writing tlie responsible authority describing the nature of the disaereement.The <br /> responsibie authority shall within 30 days eithec (a)correc[the data found to be inaccurate or incomplete and attempt to notity past recipients 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 shail be disclosed only if the individuai's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions ofdie 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 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 furnish certain private or <br /> confidential information. <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 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 pemiit or license. <br /> 4. [f your requested permit or license requires Council action to approve,some infoiznation 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 /> `TfC�.vi S � � Q-S�-�� <br /> First �liddlc Lxst <br /> /�-L l� �a��v� c� ��;n <br /> Address <br /> �E �,n�-��/�- rn� �S 3y 3 ��a-3�o�a,�`-( <br /> City State Zip Phone <br /> I understand my rights as stated nbove. <br /> �� c a���,�.gNL <br /> Signature <br /> Reset Form 32 <br />