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Sec.13A4 RIGHTS OF SLIBJECTS Or DATA <br /> Subd. 1. Type of da[a. The rights of individual on whom the data is slored or[o be stored shall be as set fo�th in this section. <br /> SuUd.2. Informationrequu-edtoUegivenindi��idual. Anindividualaskedtosupplyprivateorconfidentialdataconceminghimselfshallbe <br /> informed of: (�)the pu�pose�nd intended use of the requested data within the collec[ing state agency,political subdi��ision,or s[atewide sys[em;(b) <br /> �vhether he may refuse or is legally required to supply the reques[ed da[a;(c)any known consequence ansing from his supplying o�refusing to supply <br /> priv�te or confideniial da[a,and(d)the identity of o[her persons or entities authorized by state or federal law to receive the data. This requirement shall <br /> not apply wfien an individual is asked to supply investigative da[a,pursuant to section 13.82,subdivision 5,[o a law enforcement officer. <br /> The commissioner of revenue may place the notice required under this subdivision in the individual income tAx or nronertV tas refund <br /> insWc[ions instead of on those fo�ms. <br /> Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be infoaned whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or contidential. Upon his further request,an individual�vho is[he subject of <br /> stored priv�te or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and <br /> meaning of that data. .After an indi�idual has been shown the private dat�and informed of its meaning,the data need not be disclosed to him for si� <br /> monUis[hereaYter unless a dispute or action pu�suan[to[his sec[ion is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the pnvate or public da[a upon request by[he individual subject of the data. The responsible authonty <br /> may require the reyuesting person to pay tlie�etual costs of making,ceRifying,and compiling the copies. <br /> The responsible authorih�shall comply immediately.if possible,with am request made pursuant to[his subdivision,or within five days of <br /> the date of the request,e�cluding Satardays,Sundays and legal holidays,if immediate compliance is not posaible. Ifhe c�nnot comply with the reyuest <br /> wi[hin that time,lie shall so infonn the individual,and may have an additional five days within which to comply with the request,excluding Saturd�ys, <br /> Sunda_ys and legal holidays. <br /> SuUd.4. Procedure when data is not accura[e or complete. r1n individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To e�ercise this right,an individual shall no[ify in wri[ing the responsible authority describin�the nature ofthe disagreemenL The <br /> responsible authority shall within 30 days either: (a)correct the data found to be inaocurate or incomplete and attempt to notiYy past recipien[s of <br /> inaccurate or incomplete data,including reciPients named by the individual;or(b)notify the individual[ha[he believes[he data to be co�recL Da[a in <br /> dispute sl�all be disclosed only if[he individual's st�tement of dis�greement is included wi[h[he disclosed data. <br /> The dete�mina[ion of the responsible authorih m�y be�ppe�led pursuant to the provisions of the administrltive procedure act rela[ing[o <br /> con[ested cases. <br /> DATA PRIVACY ADVISORY <br /> In aocordance with M S. 13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request <br /> for a pemlit or license from the City of Orono or any of its departil�ents may require you to furnish certain private or <br /> confidential infomlation. <br /> You�re notified that <br /> 1. The information you furnish will be used to deteirriine your qualification for the permit or license <br /> requested. <br /> 2. You mav 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 pernlit or license. <br /> 4. If your requested permit or license requires Counci] action to approve, some infonnation 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 fiill name is required to process this application or permit. <br /> First Middle Last <br /> Address <br /> City State Zip Phone <br /> I under tand my rights as stated above. <br /> ��'` � � 0 <br /> Signature <br /> Res�t For7n 32 <br />