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i <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 secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data conceming himself <br /> shall be informed of: (a)the purpose and intended use q�the requested dam within the collecting state agency,polidcaf subdivision,or statewide <br /> rystem;(b)whether he may refuse or is legatly required to supply the requested data;(c)any Imown consequence arising from his supplying or <br /> refusing to supply privare or confidendal daa;and(d)the idenriry of other penons or enddes authorized by state or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secdon 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav�lace[he notice reouired under[his subdivision in the individual income taz or oronercv tax refund <br /> instrucrions instead of on those fortns. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,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 confidenrial. Upon his further request,an individual who <br /> is the subject of stored private or public data on individuals shall be shown rhe data without any char;e to hun and, if he desires, shall be informed <br /> of the content and meanin,of that data. Aher an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed[o him for six months thereafter unless a dispute or acdon pursuant to this section is pending or addirional data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or public dara upon request by the individual subject of the data. <br /> The responsible authoriry may require[he requesring person to pay the actual cosu of making,certifying,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 dace of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot compiy with <br /> [he request within that time, he shall so inform the individual, and may have an addirional five days within which to comply with the request, <br /> excluding Samrdays, 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 dara conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the <br /> disagreement. The respo�sible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplece and attempt to nodfy <br /> past recipients of inaccurate or incomplece data,including recipients named by the individual;or(b)nodfy the individual thac he be(ieves the data <br /> to be correct. Data in dispute shall be disciosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinaaon of the responsible authority may be appealed pursuant ro the provisions of the administrative procedure act relating <br /> to contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance wich 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 City of Orono or any of its departments may require you to furnish certain <br /> private or confidential information. <br /> You are notified [hat: <br /> 1. The information you furnish 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 pemut or license. <br /> 4. If your requested pemut 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 /> ���Y State Zip Phone <br /> I understand my rights as stated bove. <br /> `'//J� �_ <br /> v� <br /> sig tu�e <br /> 6 <br />