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� � � <br /> Sec.13.04 RIGHTS OF SUBSECTS OF DATA <br /> Subd. 1. Type of data. The rights of individua!on whom the d1[a is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individua(.An individual asked to supply private or confidential data conceming himselfshall be <br /> infortned of: (a)the purpose and intended use of the requested 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 daca;and(d)the identiry of other persons or entities authorized by state or federal law co 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 enforcemen[officer. <br /> The commissioner of revenue mav piace the notice required under this subdivision in the individual income tax orgro�ertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individuaL Upon request to a responsible authority,an individuzl shall be informed�vhether he is the subject of <br /> stored data on individuals,.and whe[her it is classified as public,private or confidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be snown the data without any charge to him and,if he desires,shall be informed of the content and <br /> meaning of that daca. After an individual has been shown the pnvate data and informed of its meaning,the data need not be disclosed to him for six <br /> months thereafrer 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 reques[by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the accual costr of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within fve days ef <br /> the date of the request,e�cluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot comp!y with the request <br /> within that time,he sha11 so infomt the individual,and may have an additional five days widlin which to comply with the request,excluding SaCsrdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contes[the accuracy orcompleteness ofpublic orprivate da[a <br /> conceming himself. To exercise chis right,an individual shall no:ify in wiiting the responsible authority describing the nature of the disagreemen[.The <br /> responsible authority shall within 30 days either. (a)con�ect the data found[o be inaccurate or incompleie and attempt to notify past recipients of <br /> inaccura[e or incomplete data,including recipients named by the individual;or(6)notify the individual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statemen[of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act rela!ing to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subj ects 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 fumish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to deternline your qualification for the pernlit or license <br /> requested. <br /> 2. You may refuse to supply data,but refusai 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 pernlit or license. <br /> 4. If,your aequested permit or license requires Council actior.to approve, some inforniation may becume <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 /> ���J-e e. � �1 c�� re✓� �C���-�� <br /> First Middle Last <br /> "'� ( l.C' ) �(�v/ S�!vlX ��C:JCCL,� <br /> Address <br /> City - '"��� .�=-��! State Zip Phone <br /> �' <br /> I unders�arnd m}�rights as st d ab,ove�. <br /> i <br /> %� / <br /> � <br /> 5igna <br /> 32 , <br /> � <br />