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� <br /> Sea 13.04 RIGHTS OF SUBJECTS OF D,�.T?, <br /> Subd. 1. Type of data. "Ihe righ�s of individual on whom the data is stored o�co be stored shall be as set forrh in this secdon. <br /> Subd.2. Informadon reqirired to be given individual. An individual asked to supply private or confidenaal data coacerning himself shall <br /> be informed of: (a)the purpose and incended use of the requesred daca wichin the collecring'state agency, polidcal subdivision,or sratewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data:(c)any Imown coasequence arising from his supplying or refusing to supply <br /> • private or confidendal data;and(d)the idenary of o[her persons or enrides auchorized by state or federal law to receive che data. This requirement shall <br /> not apply when an individual is asked to supply invesogadve data, pursuant to secdon 13.82, subdivision 5, to a law enforcemenc o�cer. - <br /> The commissioner of revenue mav place the noace r�ouired under this subdivision in the individual income tax or propem tax refund <br /> instrucdons inscead of on�hose forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuais,and whe�her it is classified as public, private or confidenaal. Upon his further request, an individual who is the subject <br /> of stored private or public data on individuals shall be shown che data wichouc any charge to him and,�if he desires, shall be informed of the content <br /> and meaning of chat data. Afcer an individuai has been shown[he priva[e data and informed of its meaning, the data need not be disclosed to him for <br /> six mon[hs thereaRer unless a dispute or accion pur5uant to this secdon is pending or addiaonal 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 subjecc of che data. The responsible authoriry <br /> may require the requesang person to pay the actual costs of making, cerafying, and compiling the copies. <br /> The responsible au[horiry shalt comply immediately, if possible, with any request made pursuant to this subdivision,or wi[hut five days of <br /> the date of the request,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within[hac time,he shall so inform[he individual,and may have an addidonal five days within wluch to comply wirh the request,excluding Saturdays, <br /> Sundays and legai holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of pubiic or pri�•ate <br /> data concerning himself. To exercise chis right,an individual shall noafy in wricing the responsible authoriry describing the na[ure of the disagreement. <br /> The responsible auchoriry shall within 30 days eicher: (a)correcc the data found to be inaccurate or incomplece and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, inciuding recipiencs named by che individual; or(b)nocify the individual that he believes che data to be correct. Data <br /> in dispute shali be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. <br /> The decerminarion of the responsible authoriry may be appealed pursuanc to the provisions of the adminiscradve procedure act relaang 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 pernut 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 wiil 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 permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to process <br /> the permit 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 this application or permit. <br /> ����� �`����..,=-i �� ��1 ;n;��N'• ''�n -'c <br /> � <br /> First �tiddle � Last <br /> \�r � <br /> ��� �� \ 1���"l''Sv_� �c�Y� CiYI�. � — <br /> Address 1 , <br /> ��V'�WNY11aEf E'N �\1��1 '�'-�\_,0 � )`��=J �:��c�� <br /> Ciry Sta[e Zip Phone <br /> I understand my ri�hts as stated above. <br /> � � � <br /> � �t ` ' � <br /> Signa re <br />