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.�► � , <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. M individual asked to supply private or confidential data conceming himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision, or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data; (c)any lrnown consequence arising from his supplying or <br /> refusing to supply private or confidendal data;and(d)the identity of other persons or enrides authorized by state or federal law ro receive the dara. <br /> This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav nlace the notice reauired under this subdivision in the individual income tax or vrocertv 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 <br /> subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request, an individual who <br /> is the subject of srored private or public data on individuals shall be shown the data without any charge to him and, if he desires,shall be informed <br /> of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six months thereafrer unless a dispute or action pursuant to this secdon is pending or additional data on the individual has been <br /> collected or created. The responsible authority shall provide copies of the private or public daha upon request by the individual subject of the data. <br /> The responsible authority may require the requesring person to pay the actual cosu of making,ceRifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision, or within five days <br /> of the date of the request,excluding Saturdays, Sundays and legal holidays, if immedia[e compliance is not possible. If he cannot comp►y with <br /> the request within that time, he shall so inform the individual, and may have an additional five days within which to comply with the request, <br /> excluding Saturdays,Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or <br /> private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing[he nature of the <br /> disagreement. The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to norify <br /> past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> 'The detemunadon of the responsible authoriry may be appealed pursuant to the provisions of the admuustrative procedure act relaang <br /> to 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 <br /> request for a permit or license from the �ity of Orono or any of its departments may require you to furnish certain <br /> private or 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 <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. 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 /> ����'//a�� .���_..,.! ._ �,��y� � <br /> First Middle Last <br /> ��i�' %�� - �- �� <br /> Address <br /> ,��1�; ��,�.__1�_ ��-�- ss�s� ���- -s�sy <br /> Cih, State Zip Phone <br /> I understand my rights as stated above. <br /> �/,�� <br /> �/�� � — <br /> Signature <br /> 6 <br />