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, <br /> - � .. <br /> Sec.13.04 RIGHTS OF S[IB.TECTS OF D�TA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set fonh in this secdon. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecang"state agency, political subdivision,or sratewide system; <br /> (b)whether he may refuse or is legally required ro suppty the reques[ed data;(c)any irnown consequence arising from his supplying or refusing to supply <br /> private or confidenaal data;and(d)the idenciry of o[her persons or enddes authorized by state or federal law to receive the data. This requirement shall <br /> no[apply when an individual is asked to supply invesrigadve data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of revenue mav place the notice reauired under this subdivision in the individual income tax or propertv tax refund <br /> instructions ins[zad of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as pubiic, private or confidenrial. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the content <br /> and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disclosed[o hun for <br /> six months thereafter unless a dispute or acrion pursuan[to this secdon is pending or additional data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the privace or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the acaral costs of makin¢, certifying, and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within ftve days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediace compliance is not possibie. If he cannot comply with the request <br /> within that time,he shall so inform the individuai,and may have an addirional five days within which to comply with the request,exciuding Saturdays, <br /> 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 private <br /> data concerning himseif. To exercise this right,an individual shall noafy in writing the responsible authoriry describing[he narure of the disagreement. <br /> The responsible authoriry shail wi[hin 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data, inciuding recipients named by the individual; or(b)notify the individual that he believes ihe data to be correct. Data <br /> in dispute shall be disclosed only if the individuai's statement of disagreement is included with the disclosed data. <br /> The determinarion of the responsibfe authoriry may be appealed pursuant to the provisions of the administracive procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri;hts of subjects of data", we would like to inform you that your request <br /> for a permit or license from the Ciry of Orono or any of its departments may require you to furnish 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 City deny the pemut or license. <br /> 3, The information may be shared with other local, state or federal agencies to the extent necessary to process <br /> 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 /> (. Your full name is required to process this application or permit. <br /> First Middle Last <br /> Address <br /> Ciry State Zip Phone <br /> I understand my rights as stated ab e. <br /> /` L' <br /> Signature <br />