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Scc.13A4 RICIiTS OF SUBJECTS OF llATA <br /> Subd. l. "I'ype of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this seclion. <br /> Subd.2. Intbnnation required to be given individual. An individual asked to supply private orconfidential dataconceming himselfshall be <br /> informed of: (a)die purpose and intended use of thc requcsted data within the col lecting state agency,pol itical subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising 1�om his supplying or refusing to supply <br /> private or contidential data;and(d)the identity of other persons or entitics au[horized by state or federal law to receive the data.This requirement shall <br /> no[apply when an individual is asked to supply investigative data,pursuant[o section 13.82,subdivision 5,to a law enforcemen[officer. <br /> The commissioner of revenue tnay place the notice reauired under this subdivision in the individual incomc tas or propertv tax refund <br /> instructions instead af on those fonns. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or contidential. Upon his tLrther request,an individual 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 informed of the content and <br /> meaning of that data. After an individual has been shown the privafe data and intbnned of its meaning the data need not be disclosed to him for sis <br /> mon[hs 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[he data. The responsible authority <br /> may require the requesting person to pay the actual costs of making,certifying and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,wi[h any request made pursuant to this subdivision,or�vilhin tive 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 requcst <br /> within diat time,he shall so inform the individual,and may have an additional tive days within which to comply with the reyuest,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 publ ic or private data <br /> concerning himseH'. To eaercise this right,an individual shall notity in writing the responsible authority describing the nawre ofthedisagreement. The <br /> responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incotnplete and attempt to notiCy past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual th�t he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with die disclosed data. <br /> The determination of the responsible authonty 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.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 infonnation. <br /> You are notified that: <br /> L The information you furnish will be used to detenuine your c�ualification 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 permit or license. <br /> 4. lf 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 /> � �G�-�n-�� �, r`1�i ��=��/ <br /> First 1 ( Middle Lxst <br /> ���w���"r-- �� <br /> Address <br /> City Statc Iin Phonc <br /> I understand my rights as stated above. <br /> �=�����u�. ����--____ <br /> Signaturc <br /> 32 <br />