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�. <br /> Sec.13.04 RIGHTS OF S[JB,TECTS 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 forrh in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecring state agency,polirical subdivision,or statewide <br /> system;(b)whecher he may refuse or is legafly required to supply the requested data;(c)any lrnown consequence arising from his supplying or <br /> refusing to supply private or confidendal dara;and(d)the idenaty of other persons or entiaes authorized by srate or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply investi;ative data, pursuant to secrion 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav place the notice reauired under this subdivision in the individual income taz or orooem tax refund <br /> instrucrions lnstead of on those forms. <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 cfassified as pubiic,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 the data without any char�e to him 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 /> d'uclosed to him for six months thereafrer unless a dispute or action pursuant to this section is pending or addirional data on the individual has been <br /> collec[zd or crea�ed. The responsible authority 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 requesdng person to pay the acNal cosu of makin�,certifying, and compiling the copies. <br /> The responsible authoriry shall comply immediate(y,if possible,with any request made pursuant to this subdivision, or within five days <br /> of the date of che request,excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with <br /> the request wi[hin 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 daa conceming himself. To exercise this right,an individual shall nodfy in writing the responsible auchoriry describing the 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 nodfy <br /> past recipiena of inaccura[e or incomplete dara,including recipients named by the individual;or @)nocify the individual that he believes the data <br /> to be correct. Data in dispute shali be disclosed only if the individual's statement of disagreement is includzd wich the disclosed data. <br /> The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relatin, <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 City 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 furnish will be used to determine your qualification for ihe permit or lice�� <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 pernut or license. <br /> 4. If your requested permit 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 [his application or permit. <br /> JCS.S z�� �o�., � �� � < <br /> First Middle Lasc <br /> - ICti �� I —C-en�-e1- /-�-�-z s� <br /> Address <br /> �.-����v ,-� -� i s 3� d- G-r� ,�-ro - /�Fs Z <br /> C��' State Zip Phone <br /> I understand my rights as state above. <br /> o-�- <br /> � � <br /> Si Nre • <br /> 6 , <br />