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� <br /> Sec.13.04 RIGH'TS OF SLTB.TECTS OF DATA <br /> Subd. 1. Type of data. The righrs of individual on whom[he data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be given individual. r1n individual asked to supply private or confidenrial data conceming himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecang'state agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requesced data;(c)any imown consequence arising from his supplying or refusing to supply <br /> private or confidencial data;and(d)the identiry of other persons or enaaes authorized by state or federal(aw to ieceive the data. This requirement shall <br /> not apply when an individual is asked [o supply investigadve da�a, pursuant to secdon 13.82, subdivision 5, [o a law enforcement officer. <br /> The commissioner of revenue mav place the noace required under chis subdivision in the individual income tax or propertv tax refund <br /> instrucrions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals, and wherher ic is classified as public, priva[e or confidenrial. Upon his fur[her request, an individual who is the subject <br /> of stored private or public data on individuals shall be shown che data wi[hout any charge to him and,'if he desires, shall be informed of the content <br /> and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to hun for <br /> six months thereafter unless a dispute or accion pursuant to this section is pending or addidonal data on the individual has been collected or creaced. <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 requesting person to pay the accual costs of making, cerrifying, and compiling the copies. <br /> The responsible authoriry shall compfy immediarely, if possible, with any request made pursuant to this subdivision, or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is no[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 when data is not accurate or complete. An individuai may contest the accuracy or completeness of public oc private <br /> data concerning himseff. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreemenc. <br /> The responsible authoriry shall within 30 days ei[her. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccurate or incomplete data, inciuding recipients named by the individual; or(b)notify the individual that he belizves 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 adminisuacive 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 information. <br /> You are notified that: <br /> 1. The information you fumish will be used to determine 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 pernut 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 pernut 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/ �-��G�Z <br /> First + Middle Las[ <br /> Address. <br /> � �v �;�f� 6 `� '3 �, .���`� �l/ 5 �� �-� ii7 <br /> Ciry State Zip Phone <br /> I understand my rights as s�ted above. <br /> � <br /> � <br /> , <br /> � <br /> Signatu e <br />