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Sec.13.04 R[GHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type oT 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. Infonnation required to be given individual. An individual asked to supply private or confidential data conceming himself shall be <br /> infonned of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse 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 identiry of other persons or entities au[horized by 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 ofticer. <br /> The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property tar refund <br /> instructions inste2d of on those fonns. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is the subject of <br /> stored dala on individuals,and whether it is classitied as public,private or contidential. Upon his further request,an individual who is the subject of <br /> stored p�ivate or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be infonned of the content and <br /> meaning of that data. After an individual has been shown the private data and infonned of its meaning the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section 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 data upon request by the individual subject of fhe data. The responsible au[hority may <br /> require the rcqucsting peison to pay the actual costs of making,ce�tifying,and compifing the copics. <br /> The responsible authority shall comply iimnediately,if possible,with any request made pursuant to this subdivision,or within tive days of the <br /> date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the reyuesl <br /> within that time,he shall so infonn[he individual,and may have an additional tive days within which to comply with the request,excluding Saturdays, <br /> Sundays and lega(holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contes[the accuracy or completeness of public or private data <br /> conce�ning 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 wiU�in 30 days either. (a)con�ect the data found[o be inaccura[e or incomplete and attempt to notily past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notiFy the individual that he believes the data[o be con�ect. Data in <br /> disput�shall be disclosed only if the individual's statement of disag�eement is included with th�discbsed data. <br /> The detennination of lhe responsible authority may be appealed pwsuant 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 departrnents may require you to furnish certain private or <br /> confidential infomiation. <br /> You are notified that: <br /> 1. The information you furnish will be used to deterniine 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 other local, state or federal agencies to die extent necessary to <br /> process the permit or license. <br /> 4. If your requested pennit or license requires Council action to approve, some infoiznation 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 /> Q��E�2T � ��21.5a� <br /> First Middle Last <br /> �C'� � �A��" �.,�1 K_� S-ft2.E.� t� <br /> Address <br /> ���--��_��, �-�►.� �53� � g��• y�y .a��c� <br /> City Statc Zip Phone <br /> I understand my rights as stated above. `� <br /> � � <br /> 'L txl <br /> Sienature <br /> 32 <br />