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. J f <br /> Sec.13.04 RIGHTS OF SiJBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom[he data is stored or to be stored shall be as set focih in this secdon. <br /> Subd.2. Information required to be given individual. P.n individual asked to supply private or co�dendal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collec[ing'stace agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse or is le2ally required to supply the requestzd data;(c)any imown consequence arising from his supplying or refusing to supply <br /> private or confidendal data;and(d)the idendry of other persons or endties authorized by state or federal law to receive the data. This requirement shall <br /> noc apply when an individual is asked to suppty invesrigarive data, pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place [he notice required under this subdivision in [he individual income tax or propertv tax refund <br /> instrucrions instead of on those forms. <br /> Subd.3. Access to data by individuaL Upon request ro a responsible authoriry,an individual shall be informed whe[her he is the subject <br /> of stored data on individuals, and whecher it is classified as public, private or co�dential. Upon his funher request,an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown[he data wichout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of that data. After an individual has been shown the pnvate data and informed of its meaning, the data need not be disclosed to him for <br /> six months thereafter unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been coflected or crea[ed. <br /> The responsible authoriry shall provide copies of the private or public data upon requesc by the individual subject of the data. The responsible au[horiry <br /> may require the requesting person to pay the actual coscs of making, cerafying, and compiling the copies. <br /> The responsibie au[horiry shall comp(y immediately, if possible, with any request made pursuant to this subdivision, or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesc <br /> within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with[he 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 complereness of public or private <br /> data concerning himself. To exercise[his right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shali within 30 days either: (a)correc[[he data found to be inaccurate or incomplete and attempt to nodfy past recipieau 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 <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> Tne determinadon of the responsib(e authoriry may be appealed pursuant to the provisions of the admuustrative 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 deternune 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 shazed 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 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 /> ` � �;,'1C • ` �`O� v� <br /> p� � 'vtiddle l ast <br /> �,��� G � C ��5��CV �7l�c� ' , <br /> ress � {� � �� � � � "— � �J l.. <br /> 'r\L/��r i l�S �'�1\��� '7 7 �� � � ..� � i�:� � <br /> �in, Stace Zip Phone <br /> �understand my rights as stated ab <br /> ..... �-� <br /> l, _ <br /> Sig�re • <br />