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� <br /> . <br /> Sec.13.04 RIGH'TS OF SUB.TECTS OF D:�T,� <br /> Subd. 1. Type of data. The righ�s of individual on whom che data is stoc:;:or to be stored shall be as set forth in this secaon. <br /> Subd.2. Information reqirired to be given individual. An individual askr.i to supply private or confidenaal data concerning himself shall <br /> be informed of: (a)the purpose and inttnded use of the requested data within the coll�ang'sta[e agency,poliacal subdivision,or sratewide system; <br /> (b)whether he may refuse oY is legally required to suppiy the requested dan:(c)any imoR�n consequence arising from his supplying or refusing ro supply <br /> priva[e or confidencial data;and(d)the idend[y of other persons or enodes authorized b}'��e or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investieaave daa, pursuant to secaon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue r�av place the nodce reauired under this s��:ivision in the individual income tax or propertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by indi�ldual. Upon request to a responsible au'Warity,an individual shall be informed whe[her he is the subject <br /> of stored data on individuals,and whe[her it is classified as public, private or confidza:al. Upon his further request, an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data wichou[any cnar_e to him and, if he desires, shall be informed of[he content <br /> and meaning of that data. After an individual has been shown the priva[e data and inic�ed of its meaning,che data need not be disclosed to him for <br /> six months thereafter unless a dispute or acaon pursuant to this secaon is pending or:r:ditional data on[he individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon reques:��+the individual subject of the data. The responsible au[horiry <br /> may require the requesting person to pay the actual costs of makine, cerdfying, and cacnpiling the copies. <br /> The responsible au[horiry shalt comply immediately, if possible, with any re�uest made pursuant to[his subdivision, or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immedia[e ccmpliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addirional five days wi[hin which to comply with the request,excluding Saturdays, <br /> Sundays and legai holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individl::1:nay contest the accuncy or completeness of public or prn•ate <br /> data concerning himseif. To exercise[his right,an individual shall notify in wridng the:�sponsible authoriry describing the na[ure of the disagreement. <br /> The responsible au[horiry shall within 30 days either. (a)correct the data found to be:^accurate or incomplete and attempt to norify past recipienu of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b)r.ec.y the individual[hat he believes the dara to be correct. Data <br /> ' in dispute shali be disclosed only if the individual's statement of disagreement is incinc.d with tile disclosed data. <br /> The determina[ion of the responsible authoriry may be appealzd pursuan[t�rhe provisions of the administrarive procedure act reladng to <br /> contested cases. <br /> DATA PRIVACY AD�TSORY <br /> In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of�:ata", w�e would like to inform you that your request <br /> for a permit or license from the City of Orono or any of its depart�ents 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��our qualification for the permit or license requested. <br /> Z. 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 ::ccion to approve, some information may become <br /> public. <br /> 5, You have certain righcs 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 Viiddle Last <br /> Address <br /> Ciry State Zip Phone <br /> I understand my �ghts as stated above. <br /> / � �<Ja-L— <br /> ' C <br /> Signature <br />