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Sec.13.04 RIGH'TS OF SUBJECTS OF D�TA <br /> Subd. i. Type of data. The righ[s of individual on whom the data is storcd or to be stored shall be as set for[h in this secaon. <br /> Subd.2. Information req�rired to be given individual. An individual asked ro supp(y privace or confideodal dara concerniag himself shall <br /> be inform:d of: (a) the purpose and in[ended use of the requestcd dam wi[hin the collecang"statt ageacy, po(idcai subdivision,or stacewide systtm; <br /> (b)wheet:er he may refuse or is legaliy required to suppiy�he requesced data;(c)any known consequeace arising from his supplying or refusing to supply <br /> priva�e or conndenaal data;and(d)the idendry of other persoas or enodes auchorized by scate or federal law to receive[he data. This requiremeoc shall <br /> not apply when an individual is ask�d to supply invescigadve dan, pursuanc to secaon 13.82, subdivision 5, co a law enforcement officer. <br /> The commissioner of revenu- mav pla�� the nodce r-auired under this subdivision in the individual income tax or orooectv rax refund <br /> instruccions inscead of on �hose forms. <br /> Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual sball be informed whether he is tho subjecc <br /> of stored data on individuals,and wherher it is classifi:d u public, private or confidendal. Upon his furcher request,an individual who is the subject <br /> of stored private or public dara on individuals shall be shown che dara wichouc any charge to hicn and,�if he desires, shall be informed of the contenc <br /> and meaning of rhat data. After an individual has bezn shown che priva�e data and informed of its meaning,[he dara need not be disclosed to him for <br /> siz monchs �hereafter unless a dispuce or acdon pursuanc eo chis secaon is ptnding or addidonal data on the individual has been collected or creaced. <br /> The responsible auchoriry shall provid�copies of the private or public data upon requesc by che individual subject of[he dara. The responsible authoriry <br /> may require che requesring person to pay the acnial cos�s of makinz, cerafying,and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, wi�h any reques�made pursuant to this subdivision,or wichin five days of <br /> the dace of the requesc,ezcluding Sanirdays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannoc comply with the requesc <br /> wichin tha!ame,he shall so inform[he individual,and may have an addidooal five days wichin wluch to comply wich�he request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may concest the accuracy or completaness of public or private <br /> data conceming himself. To exercise chis right,an individual shall nodfy in wricing che responsible au�horiry describing the nature of the disagreement. <br /> The responsible auchoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempc to noafy past recipieau of <br /> inaccurdte or incomplece data, including recipien[s named by che individual; or(b)nodfy the individual tha�he believes che data to be correcc. Data <br /> in dispute shali bz disclosed only if the individual's statemznc of disagreement is included wi[h the disclosed data. <br /> The de�erminaaon of the responsiblz aurhoriry may be appealed pursuanc to the provisions of the adminisaarive procedure act reladng 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 pernut or license from the Ciry 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 determine your qualification for the perm.it 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 wich other local, state or federal agencies to the ettent necessary to process <br /> the permit or license. <br /> 4. If your requested pecmit or license requires Council action to approve, some information may become <br /> public. <br /> j. You have certain ri�hts 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 /> �C c=: �`�3 � <br /> Firsc �tiddla Last <br /> Address <br /> Ciry Srdte Zip Phone <br /> I understand my ri�hts as stated above. <br /> � <br /> ..���_ 'C �--_ <br /> � <br /> Signacure <br />