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' - � <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be srored shall be as set forth in this section. <br /> Subd.2. Infonnation required to be given individual. An individual asked to supply p�ivate or confidential data conceming himself shall be <br /> infonned of: (a)the pu�pose and intended use of the requested data within the collecting state a�ency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential da[a;and(d)the identity of other persons or entities authorized by state or federal law to receive the da[a. This requirement shall <br /> not apply when an individual is ashed to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav place the notice required under this subdivision in the individull income tac or pronerty tar refund <br /> instructions instead of on those fonns. <br /> 5ubd.3. Access to data by individuaL Upon reques[to a responsible authority,an individual sltall be infonned whether he is the subject of <br /> s[ored data on individuals,and whethe��it is classitied as public,private or confidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be infonned of the content and <br /> meaning of that data. After an individual has been sho�m the private data and infonned of its meaning,the data need not be disdosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the piivate or public data upon request by the individual subject oY the data. The responsible authority may <br /> require the requestin�person[o pay the actual costs of making,certifying and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days ofthe <br /> date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [f he cannot compiy with the request <br /> wi[hin that time,he shall so infonn the individual,and may have an additional tive days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or piivate data <br /> concerning himselE To exercise this tight,an individual shall notify in writing[he responsible authority describing the na[ure of the disagreement. The <br /> responsible authority shall within 30 days ei[her: (a)corcec[the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be con�ect. Da[a in <br /> dispute shall be disclosed only iY the individuaPs statement of disap�eement is included with the disclosed data. <br /> The detennination of the responsible authority may be appealed pursuant to the provisions of the adminishative 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 pennit or license from the City of Orono or any of its departments may require you to fumish certain private or <br /> confidential infornlation. <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 /> 2. You may refuse to suppiy 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 perniit or license. <br /> 4. If your requested permit or license requires Council action to approve, some infonnation 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 /> `Z'Now�s �2c,i,• L�nm ERr�� <br /> First Middle Last <br /> "1��7 C'`r�t . �r� i�? 5� <br /> Address <br /> �j c--v��c MN �'�3�� 7�.s�i 7z 3 tx� <br /> Citv Statc Zip Qhone <br /> I understand rights as stated a e.� <br /> c- <br /> Signatu <br /> � <br />