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e . <br /> l <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 /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data wiihin[he collecting state agency,political subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or <br /> refusing to supply private or confidential data;and(d)the identity of other persons or en[ities authorized by state or federal law to receive Ihe data. <br /> This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav Dlace the notice reauired under this subdivision in the individual income tax or oronerri tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the i� <br /> subject of stored data on individuals, and whether it is classified as public,private or confidential. Upon his further request,an individual who ! <br /> is the subject of stored private or public data on individuals shall be shown the data without any charge to hun and, if he desires,shall be infortned 'i <br /> of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning, the data need not be ' <br /> disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible authority may require the requesting person to pay the actuai costs of making,ceRifying,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 , <br /> of the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with i <br /> the request within that time, he shall so inform the individual, and may have an additional five days within which to compiy with the request, <br /> excluding Saturdays,Sundays and legal holidays. i <br /> Subd.4. Procedure�vhen data is not accurate or complete. An individual may contest the accuracy or completeness of public or I <br /> private data conceming himself. To exercise this right,an individual shall notify in wtiting the responsible authority describing the nature of the i <br /> disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify <br /> past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data � <br /> to be correct. Data in dispute shall be disclosed only if the individuai's statement of disagreement is included with the disclosed data. i <br /> The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating I <br /> to contested cases. i <br /> DATA PRIVACY ADVISORY I <br /> In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your � <br /> request for a permit or license from the City of Orono or any of its departments may require you to furnish certain <br /> private or confidential information. � <br /> � i <br /> You are notified that: I <br /> i <br /> 1. The information you furnish will be used to determine your qualification for the permit or license i <br /> requested. I <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 permit or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become ! <br /> public. I <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 /> ^ /� /j �('\ /'� r 'y� <br /> � � I I L 1✓�V I i V Y ) �V I l 1 V �( C!��_:_�Y�Y"^��/ ,. <br /> FICSt-�� Middle Last <br /> ;�1��y`�- �_��� �. � �'� � �� � <br /> Address - <br /> �,�1 � ����� a�' �%�'�J �Y�K� �5��'� �-1����.� <br /> Ciry State Zip �Phon� ��� �j�� <br /> l�/ <br /> I understand my rights as stated abo . <br /> - ^�� � �/ <br /> Signature > <br /> 6 <br />