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� . <br /> i.. <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 indiridual. An individua!asked to supply private or co�dentiai data conceming himself <br /> shall be informed of: (a)the purpose and inrended use of the requested data wichin the collecting state agency,polidcal subdivision,or statewide <br /> system;(b)whe[her he may refuse or is legally required to supp(y che requested data;(c)any lmown consequence arising from his supplying or <br /> refusing to supply privace or confidenaal dara;and(d)the idendry of other persons or enoaes authorized by srate or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply investiga[ive data, pursuant to section 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> Th�commissioner of revenue mav lace the notice re uired under this subdivision in the individual income taz or ro em tax refund <br /> instrucrions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the <br /> subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who <br /> is the subject of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires,shall be informed <br /> of the content and meanin�of that data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed co him for six months thereaher unless a dispute or action pursuan[to this section is pending or addidonal data on the individual has been <br /> coilected or created. The responsible authoriry shall provide copies of the priva[e or public data upon request by the individual subject of the data. <br /> The responsible authority may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediarely,if possible,with any request made pursuant to this subdivision, or within five days <br /> of the date of the request, excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possibie. If he cannot comply with <br /> the request within that time, he shall so inform the individual, and may have an additional five days within which to comply with the request, <br /> excluding Saturdays,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 <br /> private data concerning himself. To exercise this right,an individual shall nocify in writing the responsible authoriry describing the nature of the <br /> disagreement. The respor�sible authoriry shail within 30 days either: (a)correct the dara found to be inaccurate or incomplece and attempt to nodfy <br /> past recipients of inaccurate or incomptete dara,including recipients named by the individual;or(b)nodfy the individual that he believes the data <br /> to be correct. Data in 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 adminis�aove procedure act relarin� <br /> to contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance wich M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your <br /> request for a permit or license from the �ity of Orono or any of its departments may require you to furnish certain <br /> private or 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 permit or license. <br /> 3. The information may be shared with o[her local, state or federal agencies to the extent necessary to <br /> process the pemut 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 /> S�a-� � �Q �;f <br /> F�rst Middle Last <br /> I � �lZ ✓�.;�he�•��q � L r �' <br /> �ddress <br /> e �I-U.~�-, h S�5' �t 9,f.L �r -9 ��,' <br /> C�ry State Zip Ph ne <br /> I understand my rights as stated above. <br /> r - <br /> Signature <br /> 6 <br />