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Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.1. Type of data. The rights of individual on whom the data is storcd or to be stored shal]be as set forth in this section. <br /> Subd.2. Information required�o be given individual. An individual asked to supply private or confidential data conceming himself shalt be <br /> informed of: (a)the purpose and incended use of[he tequested data within the collectiag state agency,political subdivispo�nYoc�statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his su l in or refusing to supply <br /> private or confidential data;and(d)the identity of other persons or entides authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked co supply investigative data,pursuant to secdon 13.82,subdivision 5,to a law enforcement officer. <br /> The comm�ssioner of revenue mav vlace the notice reauired under this subdivision in the individuai income r ro e tax reFun <br /> instructions insteud of on those forms. <br /> Su6d.3. Access to data by individuat. Upon request to a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classified az public,privnte or confidtntial. Upon his further request,an individual who is che su6ject of <br /> storcd private or public data on individuals shall be shown the data without any chazgc to him and,if he desires,shall be informed of the content and <br /> meaning of that data. Afttr an individual has becn shown the private data and informed of its meaning,the dab need not be disclosed to him for six <br /> months thereaFter unless a dispute or action pursuant to this section is pending or additional daW on the individual has been collected or created. The <br /> responsibte authoriry shall provide copies of the private or public data upon request by the individual subject of the data.Thc responsibie authority may <br /> require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shali comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the <br /> date of the request,excluding Saturdays,Sundays and lega]holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so infornt the individual,and may have an addicional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and lega(holidays. <br /> Subd.4. Procedure when data is�ot accurace or complete. An individual may contest the accuracy or comp(etencss oF pub(ic or private data <br /> conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreemenG The <br /> responsible authoriry shall within 30 days either. (a)coaect che data found to be inaccura[e or incomplete and attempt to no[ify past recipients oF <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify[he individuat that he believes the data to be correc� Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 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 will be used to determine your qualification for the permit or license <br /> 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 ]ocal, 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 on yourself. <br /> 6. Your full name is required to process this application or permit. � <br /> �� 1 j�G��n P y ��� � �{�c S��/� <br /> First M�ddle L�� <br /> � �c�b�u>c�UC�� ��� ` <br /> aaa��S C ��vv�v {��,. �53%l �'���-� �-(,'���- <br /> C�� � _� z� <br /> City <br /> State Zip Phone <br /> I understand my rig as stated above. <br /> , , / <br /> �� <br /> Signature � <br /> � � <br /> 1� <br />