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Sea 13.04 RIGHTS OF SIIBJECTS OF DATA <br /> Subd. i. Type of data. The righrs of individual on whom che data is stored or co be scored shall be as set forth in this secaon. <br /> Subd.2. Information reqirired to be given individual. .�n individual asked to suppiy private or confidenaal data concerning himself shall <br /> be informed of: (a) the purpose and intended use of the requesred data within the collecang"state agency,poliacal subdivisioo,or sntewide rysum; <br /> (b)whe[her he may refuse oY is legally required to supply the requested data;(c)any Imown coasequence arising from his supplying oc refusing to supply <br /> privace or confidendal dara;and(d)the idenriry of ocher persons or enddes au[horized by state or federal law to receive the data. 'Ihis requirement shall <br /> noc apply when an individual is asked to suppiy invesdgaave da[a, pursuanc to secrion 13.82, subdivision 5, to a law enfoccement o�cer. <br /> The commissioner of revenue mav place the norice reauired under this subdivision in [he individual income tax or propertv tax refund <br /> instruccions instexd of on�hose forms. <br /> Subd. 3. Access to data b�individual. Upon request to a responsible au[horiry,an individual shall be informed whether he is the subject <br /> of stored data on individuals, and wherher it is classified as public, private or confidendal. Upon 6is further request, aa individual who is the subjec� <br /> of stored private or public data on individuals shall be shown the data wichout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of chat data. Aftzr an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to him for <br /> six months thereafrer unless a dispute or acdon pursuan[to �his secaon is oending or addidona!data on the individual has been collected or created. <br /> The responsible au[horiry shall provide copies of the private or public data upon requesc by the individual subject of the dara. The responsible authoriry <br /> may require the requesting person to pay the ac[ual coscs of makine,cerrifying, and compiling the copies. <br /> The responsib(e authoriry shall comply immediately, if possible, with any reques[made pursuant to this subdivision,or within five days of <br /> the date of che request,excluding Saturdays,Sundays and legal holidays,if immedia�e compliance is not possible. If he cannot comply with the request <br /> wichin that time,he shall so inform the individual,and may have an addiaonal five days within which to compiy with the request,excluding Sarurdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compfeteness of public or pri�•ate <br /> data concerning himself. To exercise this right,an individual shalf noafy in wriang che responsible authoriry describing[he nature of the disagreement. <br /> The responsible aurhoriry shall within 30 days eirher. (a)correct che dara found ro be inaccurate or incomplere and attempt to nodfy past recipients of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes[he data to be correct. Data <br /> in dispuce shall be disclosed orily if the individual's sta[ement of disagreemenc is included with the disclosed data. <br /> The dererminanon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relaang to <br /> contested cases. <br /> DAT�, PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Rig.hts of subjects of data", we would like to inform you that your reauest <br /> for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or <br /> 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 requested. <br /> 2. You may refuse to supply data, but refusal may require that the Ciry deny the permit or license. <br /> 3. The information may be shared wich o[her local, state or federal a�encies to the extent necessary to process <br /> the pernut or license. <br /> 4. If your requested permi[ 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 perm.it. <br /> First Middle Last <br /> Address <br /> C��y State Zip Phone <br /> I understand my ri�hts as stated above. <br /> Signature <br />