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Sec.13.04 R[GHTS OF SUBJECTS OF DATA <br /> Subd. L Type of data. The rights of individuai on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Infonnation required to be given individual. An individual asked to supply private or confidential data conceming himself shall be <br /> infoRned of: (a)the purpose and intended use of the requested data within the collecting state a�ency,pofitical subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requiremenc shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commi�sioner of revenue mav place the notice reauired under this subdivision in the individual income tac or proneRy tax refund <br /> in ructions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned whether 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 of <br /> stored private or public data on individuals shall be shown the data wiHiout any charge to him and,if he desires,shall be infonned of the content and <br /> meaning of that data. After an individual has been shown the private data and infortned of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the piivate or public data upon request by the individual subject of the data. The responsible authority may <br /> require the requestin�person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shal!comply immediately,if possibie,with any request made pursuant to this subdivision,or within five days of the <br /> date of the request,excluding Saturdays,Sundays and legal holidays,iF immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so infonn the individual,and may have an additional five days wi[hin which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accuiate or complete. An individual may contest the accuracy or completeness of public or private data <br /> conceming himself. To exercise this iight,an individual shall notity in writing the responsible authority describing the nature of the disagreement. The <br /> responsible authority shall within 30 days either. (a)con�ect the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipienLs named by the individual;or(b)notify the individual that he believes the data to be con•ec[. Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The deteiYnination of the responsible aufharity may be appealed pursuant to the provisions of the administrative procedure act relating to <br /> contested cases. <br /> DATA PRNACY ADVISORY <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inforni you that your request <br /> for a pennit or license from the City 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 detennine 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 pennit 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 permit or license requires Council action to approve, some information may becoine <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 perniit. <br /> LJ i���� �c.> !� S/i� �f�--S- <br /> First Middle Last <br /> � 770 �47s�i» � <br /> Address <br /> C.an < <,�-��� G�_ �'s 3.SL �i z 3�-53� <br /> City Statc Zip Phone <br /> I understand my rights as st ted ove. <br /> Signature `- <br /> �2 <br />