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Sec.13.04 RIGHTS OF SUBJECTS OF D�TA <br /> Subd. I. Type of data. The righ[s of individual on whom the data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked to suppfy private or confidential dara concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecdng"statc agency,polidcal subdivision,or sratewide system; <br /> (b)whether he may refuse o'r is legally required ro supply the requested data;(c)any Imown coasequence arising from tus supplying or refusing to supply <br /> private or confidenrial data;and(d)the identiry of other persons or entides authorized by state or federal law to receive the data. This requirement s6a11 <br /> not apply when an individual is asked to supply invesdeadve dara, pursuant to secaon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�•enue mav place the noace reauired under this subdivision in the individual income tax or orooertv tax refund <br /> instructions instzad of on those forms. <br /> Subd. 3. Access to data b�individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals, and whe[her it is classified as public, private or confidendal. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data wi[hout any charge to hirn and, if he desires, shall be informed of the content <br /> and meaning of rhat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to hun for <br /> six months thereafter unless a dispute or action pursuant to [his secdon is pending or additionai data on the individual has been collected or crea[ed. <br /> The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual costs of making, certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or wichin five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possibie. If he cannot comply with the request <br /> wi[hin that time,he shail so inform the individual,and may have an addiaonal five days within wtuch 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 private <br /> data conceming himself. To exercise this rieht,an individual shall norify in wricing the responsible authority describing[he narure of the disagreement. <br /> The responsible auchoriry shail within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempe to norify past recipienu of <br /> inaccurate or incomplete data, including recipiencs named by the individual;or(b)nocify the individual that he believes the data to be correct. Data <br /> in dispuce shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. <br /> The de[ermina[ion of the rzsponsible authoriry 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 fumish 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 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 process <br /> the pemut or license. <br /> � 4. If your requested pernut 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 /> First Middle Last <br /> Address <br /> City State Zip Phone <br /> I understand my rights as stated above. <br /> / l��/S�y/'/.. F Z ���� l <br /> �� <br /> Signature <br />