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5ec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The righ[s of individual on whom the data is stored or to be stored shall be as set forth in this se:tion. <br /> 5ubd.2. Information required to be given indi��idual.An individual asked to supply private or confidential data conceming himself shall be <br /> informed of: (a)the purpose and intended use of[he requested data�vithin the collecting s[ate agency,political subdivision,orstatewide system;(b) <br /> whether he may refuse or is 1egally required to supply the requested daca;(c)any knotvn conscquence arising from his supplying or refusing m supply <br /> private or confidzntial data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requiremen[shall <br /> not apply when an individual is asked to suoply investigative data,pursuant[o section 13.32,subdivision 5,to a law enforcemenc officer. <br /> The commissioner of revenue mav pt�ce the notice required under this subdivision in the irdividual�ncome ta�or propertv tax refund <br /> instn!ctions instead of on those forrns. <br /> Subd.3. Access to data by individual. Upon request[o a responsib(e authority,an individual shall be infonned���hether he is the subject of <br /> stored data on individuals,.and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject oi <br /> stored private or public data on individuals shall be shown the data�vithout any charge to him and,if hz desires,shall6e informed of ihe content and <br /> meaning of that da:a. After an individual has been shown the pnvate data and informed of its meaning,the data need not be disclosed to him for si� <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been coltected or created. The <br /> responsible authority shall provide copies of the pnvate or public data upon requesc by the individual subject of:he daca. The responsible authonty <br /> may require the requesting person to pay[he acb�al coscs ofmaking,cercifying,and compiling the copies. <br /> I�he responsible au[hority shai!comply immediately,if possible,wich any request made pursuant to this subdivision,or tvithin five days oF <br /> the date of the request,excluding Sa[urdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comp!y with che reques[ <br /> within that[ime,he sha11 so inform the individual,and may have an additional five days widlin tvhich to complywith the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contes[the accuracy or completeness ofpublic or private data <br /> concemin¢himself. To exercise[his right,an individuat shall notify in wiiting thz responsiblz authonty describing the naRire of the disagreement.The <br /> responsible au[horiry shall within 30 days eithec (a)con�ect the data found[o be inaccura[e o:ineomplete and attempt to notify past recipients•o` <br /> inaccurate or incomptete data,including recipien[s named by the individual;or(b)notify the individual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statemen!oi disagreemen[is included with the disclosed data. <br /> The determinat;on of che respons;ble authority may be appealed pursuan�to the provisions of the administrative procedure act rela!ing 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 infom you that your request <br /> for a permit or license from the City of Orono or any of its departrrients may require you to fumisl�certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish wi11 be used to deter.m.ine your qualification for the pernlit o. Iicense <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the pe:mit or(icense. <br /> 3. The information may be sha:ed �,vith other local; state or federal a�encies to the extent necessary to <br /> process the perniit or license. <br /> 4. If,your requested permit o:license requires Council act:or: to approve, some infom7ation may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04(availanle upon request)to:evie�,v private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> �wE �apfv�� /��Cr�/� . <br /> Birst IY[iddle Last <br /> < < • <br /> �//��� � � � � % G' / � �� <br /> Address <br /> ��-� 4�.� � s�y�� ��.-� ��i-yy��.� <br /> C�ty State Zip Phone <br /> d understand my rights as stated above. <br /> � <br /> % �-�7� �. <br /> `'S`ignature <br /> /,�' <br /> � 3� <br />