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_ �, <br /> Sec.13.04 RIGHTS OF SLJB.TECTS OF D�TA . <br /> Subd. 1. Type of data. The righrs of individual on whom[he data is stored or to be stored shall be as set fonh in this secaon. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenaal data concerning himself shail <br /> be informed of: (a)the purpose and intended use of the requested data within the collecang"state agency, poliacal subdivision,or sratewide system; <br /> (b)whe[her he may refuse oY is legally required to supply the requested data;(c)any lmown consequence arising from his suppiying or refusing to supply <br /> private or confidendal data;and(d)the identiry of other persons or enddes authorized by stace or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesaeadve dam,punvant to secdon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the notice reauired under this subdivision in the individual income tax or oropertv tax refund <br /> instructions ins[ead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whecher he is the subject <br /> of stored data on individuals,and wherher ic is classified as public, private or confidendal. Upon his further request, an individual who is the subject <br /> of stored private or public dara on individuals shall be shown[he data wi�hout any charge to him and, if he desires, shall be informed of the contenc <br /> and meaning of that data. Aher an individual has been shown�he private dara and informed of ics meaning, the dara need not be disclosed to him for <br /> six monrhs thereafrer unless a dispute or acaon pursuant to this secdon is oending or addidonal data on the individual 6as been collected or created. <br /> The responsibie au[horiry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesdng person to pay the actual costs of making, cerufying, and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, wich any request made pursuant to this subdivision,or within 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 rhat time,he shall so inform the individual,and may have an addirional Five days within which to compiy with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accutacy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shall noafy in wridng the responsible authoriry describing[he nature of the disagreemeot. <br /> The responsible auchoriry shall wichin 30 days eicher: (a)correct the data found to be inaccurate or incomplete and attempt to noafy past recipients of <br /> inaccucate or incomplete data, including recipients named by che individual;,or(b)notify the individual that he believes the 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 /> Tlie de[erminarion of the rzspensible authoriry may be appealed pursuant to the provisions of the adaunistrarive procedure act relacing 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 inform you that your request <br /> for a pemut 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 deternune your qualification for the pemut 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 a�encies 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 ri�hts under N1.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 Vtiddle Last <br /> Address <br /> Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> Signature <br />