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. <br /> Scc.13.Od RIGEITS OF SUBJECTS OF DATA <br /> Subd. L Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or contidential data concernin�himselfshall be <br /> informed of: (a)the purpose aiid intended use ofthe requested data�vid�in the collecting state agency,political subdivision,or statewide systero;(b) <br /> �vhether he may retLse or is legally required to supply the rcquested data;(c)any kno�vn consequence arising from his supplying or reftising 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 requirement shal l <br /> not apply when an individual is asked to supply investigative data,pursuant[o section 13.32,subdivision�,to a law enforcement ofFicer. <br /> The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or nropertv tax reflind <br /> instructions instead 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 of <br /> stored data on individuals,and whether it is cfassitied as public,private or contidential Upon his further request,an individual�vho is the subject of <br /> stored private or public data on individuals shall be sho�vn the data without any char�e to him and,if he desires,shall be infonned of the content and <br /> meaning of that data. Atter an individual has been shown the private data and informed of its meaning,thc data need not be disclosed to him for siz <br /> months thereafter unless a dispute or action pursuant to this section is pcnding or additional data on the individual has been collected or crea[ed. The <br /> responsible authority shail provide copies ofthe private or public data upon request by die individual subject ofthe data. The responsible aufhority <br /> may require the requesting person to pay die actual costs of makine,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,iY possible,�vith any request made pursuant to this subdivision,or within tive days of <br /> the date ofthe request,e�duding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannof comply with die request <br /> within that tiine,he shall so inform the individual,and may have an additional tive days�aithin�shich to comply with the request,excludine Saturdays, <br /> Sw�days and legal holidays. <br /> SuUd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness oFpublic or private data <br /> concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The <br /> responsible authority shall within 30 days either (a)correct the data found to bc inaccur2te or incomplete and attempt to notifi�past recipients of <br /> inaccurate or incomplete data,induding recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only iPthe individual's statement of disagreement is included with the disciosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure acc relating to <br /> 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 infonn you that your request <br /> for a permit 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 /> l. The inforniation you furnish will be used to determine your quali.fication for the permit or license <br /> requested. <br /> _. YULI 1112y i"Zfii52 io supply data,but refusal r,ay�CeC1Uiic iilat tiiC Cliy'Cii,i�y'iiiC�ieii�ii�0�licer,se. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to <br /> process the pernlit or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> �. You have certain rights w�der 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 /> First Middle Last <br /> :�ddress <br /> Cih Statc Zip Phonc <br /> I understancl my rights ns stlted above. <br /> Si�nature <br /> ReseY Form �—' <br />