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1 <br /> Sec.13.04 RIGHTS OF StiBJECTS OF DATA ' <br /> Subd.1. Type of data. The rights of individual on Nhom the data is stored or to be stored shall be u set forth in this section. <br /> Subd.2. Information required to be given individual. .an indi�idual asked to supply private or confidential data concerning himself shall be <br /> in[ormed of: (a)the purpose and intended use ot the requested dita within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requestrd data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity o(other persons or entities authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigative datL pursaant to section 13.82,subdivision 5,to a Iaw enforcement officer. <br /> The commissioner of revenue mav olace the notice re�uired aader this subdivision in the indicidual income tax or orooertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. tipon request tu n responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuais,and whether it is classified 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 wit6oat any charge to him and,if he desires,shall be informed o[the content and <br /> meaning of that data. After an individual has been shown the prirate data and informed of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this secoon is pending or additional data on the indi�idaal has been collected or created. The <br /> responsible authority shall provide copies of the private or public dita upon request by the individual subject oCthe da[a. The responsible authority may <br /> require the requesting person to pay the actual costs of making,certifyins.and compiling the copies. <br /> The responsible authority shall comply immediately,if possible.w ith any request made pursuant to this subdivision,or within Tive days of the <br /> date of the request,excluding Saturdays,Sundays and legal holida�s,i(immediate compliance is not possible. I[he cannot comply with the request within <br /> that time,he shall so inform the individual,and may have an addi000al fi�e days within which to comply with the request,excluding Saturdays,Sundays <br /> and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complae. An individual may contest the accuracy or completeness of public or private data <br /> concerning himselL To esercise this right,an individual shall nodh-in wrimng the responsible authority describine the nature of the disagreement. The <br /> responsible authority shall within 30 days either: (a)correct the data foond to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individuil;or(b)notify the individual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statement o[disa�reement 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 PRIV�CY ADVISORY <br /> In accordance�r�ith NI.S.13.04,Subd.2,"Righu 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 an��of its departments may require}•ou 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 ma�•require that the City den�•the permit or license. <br /> 3. The information may be shared with other local,state or federal agencies to the extent necessary to process <br /> the permit or license. <br /> 4. If your requested permit or license requires Council actio� to approve, some information may become <br /> public. <br /> 5. You have certain rights under M.S. 13.0� (a�-ailable upon request) to re�-ie��•private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> �� ,_ ,�� fi � <br /> � ;- ��r� � <br /> F�rst Middle Last <br /> '� l S 3 � L C 5� ��f' �'�,��� � l� � <br /> Address <br /> �������� 1 1 I �V �� � � � ��� � � � �� � � ,�i_J��� <br /> C�4' State Zip Phone <br /> I understand my rights as stated above. . <br /> �- <br /> � �� 5�� � �"�_' <br /> S�gnature " <br />