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Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> � 5ubd.1. Type af data. The rights oF individual on whom tl►e data is stored or Io be stored shall be as set forth in this sectioa. <br /> Subd.2. Infotmation required to be given individual, An individuel asked to supplyprivate or confidential data concerning himgelfshal]be <br /> inforcned of. (a)the purpose end intended use ofthe requesbecf data within the collecting state egency,politicel subdivision,ot sfatewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(o)eny known consequence arising fromhis supplying or refusing to supply <br /> privete or confidential data;and(d)the identity of othcr persons orendties authoriud by staie or faderal law to receivethe data. This requirement sltell <br /> not apply when an individual is askod to supply investigative data,pursuanf to section 13.82,subdivision S,to a law enforcement ofticer. <br /> The com iccianer of r�enue may plaee the notice required under thic subdivision in the individual income AY o�p��rtv fax refund <br /> in3tructions mstead of on those fom�. <br /> 5uhd.3. ?.ccess to data by individual. Upon request to a responsible aulhority,an indiv;dual shall be informed whether he is the subjecc of <br /> stored data on individuais,and whether it is classified as public,private or confdential. Upon his further request,an individual who is the subject of <br /> storod private or public data on individuals shall be shown the data without any charge to hun and,ifhe des►res,shall be informed ofthe contcnt sad <br /> meaning oftha[data. ARer an individual hes been shown the private data and informed of its meaning,the dats need not be disclosed to him for siz <br /> moeths thereaRer unless a dispute or action pursuaot to this section is pending or additional data on the individual has been collected oi created. The <br /> respoosible authority shall provide copies of tNe private or public data upon request by the individual subject of the data. The responsi6le authority <br /> may reyuire the requesting person to pay the actual eosts of making,certifying,and compiling the capies. <br /> The responsible authority shall comply immediate ly,ifpossible,witfi any requesl made pwsuanl to this subdivision,or within five dgys of <br /> the date ofthe request,excluding Saturdays,Sundays and legal holidays,if imrr►ediate compliance is not possibla If he cannot eomply with d►e tequesi <br /> within thattime,hc shall so infvrm the individual,and may have an additional five days within which to comply with N�erequest,exc[uding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete.An individusl may contest the eccuracy or completeness of public orprivate data <br /> concerning himself. To exercise this right;an individual shall notify in writing the responsible authority describing the nature ofthe disagroea�ent. The <br /> tesponsible suthority shal]witBin 30 days either: (a)correct the data found to be inaccurate or inoomplete and attempt to notiCy past recipients of <br /> inaccurate or incomplete data,including zecipients named by d�e individual;or(b)notify the individua]thatha believes the datn to be concct. I3ata in <br /> disputc shal]be disclosed�nly if the individuaPs statemcnt of disagreement is included with the disclosed data. <br /> The determination of fhe responsible suthorily may be appealcd pursuant to the provisions ofihe administrative procedure act relating to <br /> contested eeses. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inforrn yau that yout 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 /> 1. The information you furnish wi11 be used to detemvne your qualification for the permit or license <br /> 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 agencies to the extent necessary to <br /> process 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 rights under M.S. 13.04 (available upon request)to review private data an yoiu�self. <br /> 6. Yow full name is r uired to r cess this application or permit. <br /> First � � ` � �a� Lest <br /> Addreee <br /> �>.�c � �, rnu�1 S�Z� C.�l --��� - <br /> City 5tah Zlp Phone J�-� � <br /> I unders nd my rights a d above. <br /> Sign ture <br /> k h � � ��. }I F � � .7-` I � �,{ <br /> h�1 I� � � I�k 3� I �k �LL�g ! {-;g. JG <br /> � ��i�t �t ����� �;,a��'`��_;'���E fi, �t�" �� <br /> E 'd 06 T 9frL9 T S9 1I W�J3d Q '8 S �1 Wd�iO � T T LOOZ 9Z qa� <br />