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� , <br /> Sea13.04 RIGH'TS OF S[JBJECTS OF DaTA <br /> Subd. I. Tvpe of data. The rights of individual on whom the data is stored or[o be s[ored shall be as set forth in this secdon. <br /> Subd.'_. Information reqirired to be given individual. ?.n individual asked to supply private or confidenrial data concerning himself shall <br /> be informed of: (a)the purpose and intended use of[he requested data wi[hin the collecting'state a�ency,polidcal subdivision,or statewide system; <br /> (b)whe[her he may refuse oY is legalty required to supply the reques[ed data;(c)any laiown coasequence arising fmm his supplying or refusing to supply <br /> priva�e or confidenrial data;and(d)the iden�ity of o[her perso�s or enrides auchorized by sta[e or federal law[o receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesdeadve dara, pursuant to seccion 13.82, subdivision�, to a law enforcement officer. <br /> The commissioner of re�enue mav place the notice reauired under[his subdivision in the individual income tax or propertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by indi�idual. Upon request to a responsible au[hority,an individual shall be informed whether he is the subjecc <br /> of stored data on individuals, and whe[her it is classified as public, private or confidenaal. Upon his further request, an individual who is the subjec[ <br /> of stored private or public data on individuals shall be shown[he data without any cnarge to him and, if he desirzs, shall be informed of the content <br /> and meaning of that data. Aftzr an individual has been shown the private data and informed of ics meaning, che data need not be disclosed to him for <br /> six monrhs thereafter unless a dispute or acrion pursuan[to this secdon is pending or addiaonal data on the individual has been collected or crea[ed. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subjec[of the data. The responsible authoriry <br /> may require the requesting person to pay [he actual cosu of making, certifying,and compiling the copies. <br /> The responsible au[horiry shall comply immediatzly, if possib(e, with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and leeal holidays, if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not aceurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate <br /> data concerning himself. To exercise this right,an individual shall notify in writing the responsible auchority describing[he nature of the disagreement. <br /> The responsible au[horiry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to norify past recipienrs of <br /> inaccurate or incomplere data, including recipients named by the individual; or(b)notify the individual that he believes�e data to be correc[. Data <br /> in dispute shall be disclosed only if the individual's statemen[of disagreement is included with the disclosed data. <br /> Tlie determination of the responsible authoriry may be appea(ed pursuant to the provisions of the administrarive procedure act relad�g to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "RiQhts of subjects of data", we would like to inform you that your reauest <br /> for a permit or license from the City of Orono or any of its depar[ments 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 your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the Ciry 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 pemut or license. <br /> 4. If your requested pernut or license requires Council action to approve, some information may become <br /> public. <br /> j. 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 applica[ion or permit. <br /> First tiiiddle Las[ <br /> Address <br /> City Sta[e Zip Phone <br /> I understand my rijhts as stated above. <br /> ��'Y� S� <br /> Signature <br />