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Sec.13.04 RIGHTS OF SUBdECTS OF DATA <br /> Subd.1. Type of data. The ri�;hts of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd 2.Information required to be given individual.An individual asked to supply private or confidential data concerning hirnself shall be <br /> informed of: (a)the purpose and intended use of the requested data within[he collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may iefuse 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 data;and(d)the identity of other penons or entities authorized by state or federal law to receive the data.This requirement shall <br /> aot apply when an i�dividual is asked to supply investigative data,pursuant[o section 13.82,subdivision 5,to a law enforcement officer. <br /> 'I'he commissioner of revenue may_place the notice rec�uired under this subdivision in the individual in ome t�x or�rooertv tax refund <br /> instruc[ions instead of on those forms. <br /> Subd.3. Access to data by individual.Upon reques[to a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classi£ied as public,private or confideneaL 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 chazge[o him and,if he des'ves,shall be informed of the content and <br /> meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed m him for six <br /> months thereafter unless a dispute or action pursuant to this sec[ion is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the private or public da[a upon request by the individual subjec[of[he da[a. The responsible au[hority <br /> may require the requesting pe�son m pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pu�suant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if irnmediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,e�ccluding 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 data <br /> conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.The <br /> responsible authority shall within 30 days either. (a)correc[[he 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 correct. 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 ac[relaung to <br /> con[ested 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 /> 2. You may refuse to supply data,but refusal may require that the City deny the pernut 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 /> p ub lic. <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 /> ���.i�,�� �,,�p'�, �C1-,�����/ <br /> First Middle Last <br /> ��4� ���� ���� �ti <br /> Address � <br /> �Zr�.ti� �ti� �; 3 ;�� > >� Z y� ,� -z,�<� � <br /> City State Zip Phone <br /> I understand my righ d above. <br /> f ,� -� j t <br /> � ure <br /> 32 <br />