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/ <br /> E • ' <br /> � <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 stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. ,1n individual azl.ed to supply private or confidential data concerning himself shafl be <br /> informed of: (a)the purpose and intended use of the requested data within the mllectis�state a;ency,polltical subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)an��l-nawa consequence arising from his suppl�•ing or re[using to supply <br /> private or confidential data;and(d)the identity of other persons or entities author¢ed b�state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav olace the notice reaaired under this sub�{'nision in the individual income ta� or orooertv tar refund <br /> instructions�nstead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible aothoritc,an individual shall be informed w hether he is the subject of <br /> stored data on individuais,and whether it is classified as public,prn�ate or con(idential. L-pon his further request,an indi�-idual who is the subject oC <br /> stored private or public data on individuals shall be shown the data without an}•cha se ro 6im and,if he des(res,shall be informed of the content and <br /> meaning of that data. After an individual has been shown the pricate data and informe�o[its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this secrion is pending or additioaal data on the individual has been collected or created. The <br /> responsible authority shall provide copies o[the private or public daLa upon request b}•thT individual subject of the data. The responsible authority may <br /> require the requesting person to pay the actual costs of making,certifying,and compiling t6e copies. <br /> The responsible authority shall comply immediately,if possible,with an.-requtst made pursuant to this subdivision,or within five days of the <br /> date of the request,escluding Saturdays,Sundays and legal holida�s if immediate rnmpliznce is not possible.If he cannot comply with the request within <br /> that time,he shall so inform the individual,and may have an additiooaJ five days N ithin w hich to comply with the request,eccluding Saturdays,Sundays <br /> and Iegal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An Individual may-cootest the accuracy or completeness of public or private data <br /> concerning himself. To exercise this right,an individual shall notif}-in writing the respoo.n"ble authority describing the nature o(the disagreement. The <br /> responsible authority shall within 30 days either: (a)correct the data found to be inac�nrate or incomplete and attempt to noti(y p�st reciplents oC <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notif}-the individual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statement oC disagreement is incloded K�ith the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to rhe provisions of the admin(strati�•e procedure act relating to <br /> contested cases. <br /> DATA PRIVACY AD�TSORY <br /> In accordance with 11�I.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform�-ou that your request <br /> for a permit or license from the City of Orono or an�-of its departmenu may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish�vill be used to determine your quali5cation for the permit or license 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 process <br /> the permit or license. <br /> 4. If your requested permit or license requires Council acuon to approve, some information may become <br /> public. <br /> 5. You have certain rights under M.S. 13.0-3 (available upon request) to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> S-��� ��,us'�✓u.c��`��� .Ze�—u�?�s �. � s���� <br /> Z✓ • ��li,^is' <br /> F�rst Nliddle Last <br /> _ }`,T�� S��GI� .5�,�-�.f <br /> Address <br /> �li���'b�,k� 1�'N S`�-'�i)' �F i z) 5`0,� j��r <br /> C��' State Zip Phone <br /> I understand my rights as stated above. . <br /> 1�������� -����� <br /> S�gnature � <br />