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_. ! <br /> . l <br /> Sec.13.04 RIGHTS OF SLTB.TECTS OF DATA <br /> Subd. 1. Type of data. The rights of individuai on whom the data is stored or to be stored shall be as set forth in this secaon. <br /> Subd.2. Inforcnation required to be given indiridual. An individual asked to supply private or confidencial data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide <br /> system;(b)whzther he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or <br /> reCusing co supply private or confidential data;and(d)the idenary of other persons or endaes authorized by srate or federal law to receive the data. <br /> This requiremznt shall not apply when an individual is asked to supply investigacive data, pursuant to secdon 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav lace the nocice re uired under[his subdivision in the individual income taz or ro ertv tax refund <br /> instrucrions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shail be informed whether he is the <br /> subject of stored data on individuals,and whether it is classified as public,private or co�dential. Upon his further request,an individua]who <br /> is the subject of stored private or public data on individuals shall be shown the data wirhout any char�e to hirn and, if he desires,shall be informed <br /> of the content and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning,the data need not bz <br /> disclosed to him for six months thereafrer unless a dispu[e or action punuant to this secrion is pending or addidonal data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible au[hority may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies. <br /> The responsible authority 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 Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with <br /> the request wichin that cime, he sha(1 so inform the individual, and may have an addirional five days within which to comply with the request, <br /> excluding San;rdays,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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the <br /> disagreemenc. The responsibie authoriry shali within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify <br /> past recipienrs of inaccunce or incomplece dara,includin�recipienu named by the individual;or(b)notify the individual that he believes the data <br /> to be coaect. Data in dispute shall be disdosed only if the individual's statement of disagreement is included with the disclosed data. <br /> "Ihe determination of the responsible authoriry may be appealed pursuant to the provisions of the adminis�ative procedure act relaang <br /> to contested cases. <br /> D�TA 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 City of Orono or any of its departments may require you to fumish certain <br /> private or confidential information. <br /> You are notified that: <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 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 /> r � � G�� <br /> First `liddle Last <br /> , v � � 'L � � <br /> Add ss , <br /> / � <br /> � � r / - �• r , � �� <br /> ?L; _ <br /> C�ry State Zip Phone <br /> � <br /> I unde and rights as tated ab e. <br /> `. <br /> .i ,� � <br /> Signatur� . <br /> � <br /> 6 , <br />