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� � <br /> Sea13.04 RIGHTS OF SLIB.TECTS OF DATA � <br /> Subd. 1. Type of data. The righrs of individual on whom[he data is stored or to be scored shall be as set forth in this secrion. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial dara concerning himself shall <br /> be informed of: (a)the purpose and inteaded use of the cequesud dara within the collecting"state agency,poliucal subdivision,or sratewide system; <br /> (b)whether he may refuse oY is legally required to supply�he requested data;(c)any�own coasequence arising from his supplying or refusing to supply <br /> private or confidentiai data;and(d)the idenriry of other persoas or enrides authorized by state or federal law to receive�e data. Tfvs requiremeat s6all <br /> not apply when an individual is asked to supply invesdgadve data, pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the nodce rewired under this subdivision in the individual income rax or propem rax refund <br /> insttucdons inscead 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 subject <br /> of stored data on individuals,and whe[her it is class�ed as public,private or confidendal. Upon his further request,an individual who is the subjecc <br /> of stored private or public dara on individuals shall be shown the dara without any charge to him and,�if he desires,shall be informed of the content <br /> and meaning of that data. Afrer an individual has been shown the private data and informed of iu meaning,the dara need not be disclosed to him for <br /> six monrhs thereafter unless a dispute or acaon pursuant to this secrion is pending or addidonal dan on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesang person to pay the acmal cosu of making, certifying,and compiling the copies. <br /> The responsib(e authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of <br /> the da[e of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate <br /> data concerning himself. To exercise this right,an individual shall nodfy in wriang the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplece and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, including recipients named by the individual;or(b)noafy the individual thac he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act reladng to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Righu 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 information. <br /> You are notified that: <br /> 1. The information you furnish will be used to detemune your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the pemut or license. <br /> 3. The information may be shared with other local, state or federal agencies to the eztent necessary to process <br /> the permit or license. <br /> 4. If your requested perm.it 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 /> First Middle Last <br /> Address . <br /> Ciry Srate Zip Phone <br /> I understand my rights as stated above. <br /> �� "// /'��-�� ` �L�-2 C�1`.', <br /> LJ <br /> Signaturo <br />