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� <br /> .la� , ,�. <br /> Sec.13.04 RIGHTS OF SLJB.TECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom che data is scored or to be scored shall be as set forth in this secdon. <br /> Subd.2. Information reqirired to be given individual. �.n individual asked to supply private or confidenaal data concerning hunself shall <br /> be informed of: (a) the purpose and intEnded use of Ihe requested data within the collecting'state agency, political subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identiry of other persons or enrides au[horized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investieadve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of re�enue mav place the norice reauired under this subdivision in the individuai income tax or proPertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by indi�idual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and wherher it is classified as pubiic, private or confidencial. Upon his further request,an individual who is the subject <br /> of stored private or public da[a on individuals shall be shown the data wichout any charge to hun 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 iu meaning,che data need not be disclosed to him for <br /> six months thereafter unless a dispute or action pursuant to this secdon is pending or additional data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible auchority <br /> may require the requesring person to pay the actual cos[s of making, certifying, and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, wi[h 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. If he cannot comply with the request <br /> within that time,he shall so inform[he individual,and may have an addicional five days within which to comply wi[h the request,excluding 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 pubiic or private <br /> data conceming himself. To exercise rhis rieht,an individual shall nodfy in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsible au[horiry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt ro norify 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 <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The de[ermination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relaang 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 deternune your qualification for the pemut 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 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 /> (. Your full name is required to process this application or permit. <br /> �/ � ' f � <br /> First vliddle Last <br /> -�.7 �S- �o� �?���. <br /> —� / <br /> Address �� � /.�� j �j=;�C! ! " ( ��`t <br /> N <br /> City State Zip Phone <br /> I <br /> I understand my!�ights as stated . ve. <br /> i;; <br /> , -- , �'/l�-= <br /> Signature <br />