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. , <br /> . <br /> Sec.13.04 RIGFiTS OF SliBJECTS OF D.aT� <br /> Subd. 1. Type of data. 'l�e righ�s of individual on w6om[he data is stored or to be scnred shall be as set forth in this secaon. <br /> Subd.2. Intormatiun required to be given individual. An individual uked to supply private or confidendal data concerning himself shall <br /> be informed of: (a) the purpose and ineended use of[he requested data within the collecang State agency, polidcal subdivision, or sntewide rystem; <br /> (b)whe�her he may refuse or is fegaily required ro supply�he requested data;(c)any Irnown consequence arising from his supplying or refusing to supply <br /> priva�e or confidential data;and(d)ch�;den�iry of ocher persoas or enrides auchorized by state or federal law ro receive the data. This requiremeoc shall <br /> not apply when an indi�idual is asked co supply invesdgaave dam, pursuant to section 13.82, subdivision 5, to a law enforcem�oc o�cer. <br /> Thz commissioner of revenue mav plac� the norice reauired under this subdivision in the individual income tax or vropem rax refund <br /> instructions ins:_ad of on �hcs� torms. <br /> Subd. 3. Access to data by indi��idual. Upon request to a responsible authority,an individual shall be informed whe�her he is�he subject <br /> of s�ored data on individuals, and whecher i�is ciassified as public, private or confidential. Upon his further request, an individual who is the subject <br /> of scor:d privace or public daca on individuals shall be shown the dara wi[hout any charge to him and,�if he des'ues, shall be informed of the conrent <br /> ar.d mearung et�hat daca. Af�er an individual has been shown[he private data and informed of its meaning, the dara need not be disclosed to hun for <br /> six monchs thereaher unless a dispu�e or acaon pursuant to ehis section is pending or addiaonal data on the individual has been collecced or creaced. <br /> The responsible auchoriry shaf;providz copies of che private or public data upon request by the individual subject of[he data. The responsible authoriry <br /> may require the requesring person ro pay ehe ac�ual cosu of making,cervfying,and compiling the copies. <br /> The responsible authorin shall comply immediately, if possible, with any request made pursuant ro this subdivision, or wi�hin five days of <br /> che dace of the request, ezcluding Sacurdays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannot comply wi�h che request <br /> wi�hin rha[[ime, he shall so iniorm che individual,ar,d may have an addidonal five days within which to comply with the request,exciuding Saturdays, <br /> 3undays and legal holidays. <br /> Subd.4. Procedure when data�s not accurate or complete. An individual may conrest the accuracy or completeness of public or pri��ate <br /> dac�concerning himself. To zxereise chis nehc,an individual shall nodfy in wriang the responsible authoriry describing[he nature of the disagreemeot. <br /> The responsible aurhonry shali wi�hin 30 day s ei;her. (a)correct the data found to be inaccurate or incomplete and attempt to noafy past recipiencs of <br /> inaccura[e or incomplete da�a, includinz recipier,�s named by the individual„or(b)noufy the individual that he believes [he data to bz correc[. Data <br /> in dispu�e shall be disclosed only ii�he ir.dividua;'s s[acemenc of disagreement is included with the disclosed data. <br /> Tlit dererr.linadon of�he r�sp nsioie au:hunry may be appealed pursuant to the provisions of the adminisa-arive proc�dure ac� reladng to <br /> contesced cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance wi�h M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your request <br /> for a pemut 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 [har. <br /> 1. The infonnation you furnish will be used to determine your qualification for the permit or license requested. <br /> ?. You may refuse to supply da[a, but refusal may require that the City deny che permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the exten[ necessary to process <br /> the permit or license. <br /> d. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> 5. You hav� cenain ri�hts under N1.S. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is required �o process this application or permit. <br /> ���'1%�� <br /> First Middle Last <br /> Address <br /> C��y State Zip Phone <br /> I und�rs d y ri�hts as s�a[ed u���ove. <br /> � � <br /> Signa�ur <br />