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Sec.13.04 R1GH"1'S OF SUBJEC7'S UF llA'1'A <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set fonh in this section. <br /> Subd.2. Inli�rma(ion ree{uired lo be given individual. An individual nskeJ lo supply privnte orcurtfi�entiai delaconceming himsell�shall be <br /> informed of. (a j the purpose and intended use of the requesied data within the collecting state agency,political subdivision,or statewide system;(b) <br /> 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 identity of other persons or entities authorized by state or federal law to receive the data. This requiremeni shall <br /> not apply whcn an individual is askcd to supply invcstigatirc data,pursuant to scction 13.32;subdivision 5,to a law cnforccmcnt officcr. <br /> The co�tuuissioner of revenue ina}_place the notice reyuired under tl�is subdivision iu the iudividual income ta�ur properri ta�refnnd <br /> instructiuns inste�d of on those forms. <br /> Subd.3. :lccess to data by individual. Upon request to a responsible authority,an individual shall be infornted whethc�he is the subject of <br /> stored data on individaals,and whether it is classilied as pubiic,private ar contide�itial. lJpon his further reques't,an individuai who is the subject of <br /> stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informcd of the content and <br /> meaning of that data. After an individual has bzen shown the private data and infomied of its meaaing,the data need not be disclosed to him for six <br /> months thereafter untess a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. '1'he <br /> responsible authority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authoriry <br /> may require the requesting person to ray the acival costs nf making,certitying,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 of <br /> the date of thc rcqucst,cxcluding Saturdays,Sundays and legal holidays,if immediate compliance is not possiblc. Ifhe cannot comply with the rcquest <br /> within that time,he shall so inform the individual,and may have an additional tive days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Suhd.4. Procedure when data is not accurate or complete. An indrvidual may cantest the accuracy or comPleteness ofpublic or�rivate data <br /> concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement.The <br /> responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attcmpt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named h��the individual;or(b)notify the individual that he believes the data to he correct. l�ata in <br /> disputc sl�all bc discloscd only if tl�c individual's statcmcnt of disagrccmcnt is it�dudcd with thc discloscd data- <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04,Subd.Z,"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 /> contidential information. <br /> You are notified that: <br /> i. The information you furnish will be used to determine your qualification for the permit or license <br /> requested. <br /> 2. Yau may refuse to supply data,but refusal may require that the C ity deny the per►nit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to <br /> pracess the perrnit or license. <br /> 4. If your requested permit or license requires Councii 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 /> ��S�n I`��.�nwGl 1"�� �6�" Nv�c��'�^e.r�.� �y�urr <br /> First Middle Last C�—`f=��°r5 �ti�, <br /> "tc��� �� l-�y�w�i <br /> Address <br /> Le.���� y�r�� .�Sc�►�t ���-�3- ! ��-I <br /> Cit,y State Zip Phone <br /> 1 understand ri hts as at d above. <br /> � <br /> Signature <br />