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i <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> 5ubd. 1. Type of data. The rights of individual on whom che data is stored or[o be s[ored shall be as set fortlt in this section. <br /> 5ubd.2. Information required to be given individual.An individual asked to supply private or confiden[ial data conceming hin�self shall be <br /> informed of: (a)the purpose and intended use of the requested data within the collectine state agency,political subdivision,or statewide system;(b) <br /> �vhether he may refuse or is 1egally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential daca;and(d)[he identity of other persons or entities authorized by stafe or federal law to receive the data. This requiremen[shall <br /> no:apply when an individuat is asked to supply investigative da[a,pursuant to section 13.32,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav ntice the notice required under this subdivision in the individual income ta�or propertv ta�refund <br /> instruc[ions ins[ead of on those ferms. <br /> Subd.3. Access to data by individual. Upon request[o a responsible authoriry,an individual shall be informed�vhether he is the subject of <br /> stored data on individuals,.and whether it is classified as public,priva[e o;confidential. Upon his fui-ther request,an individual who is the suoject oi <br /> stored pnvate or public data on individuals shail be shown the data�vithout any charge to him and,if hz desires,shall be informed of ihe contenc 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 to him for si� <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 reques�by the individual subject of the data. The responsible authonty <br /> may require the requesting person to pay the acC�al cos[s ofmaking,ceRifying,and compiling the copies. <br /> Thc responsible authority shail comply immediately,ifpossible,wich any requesc made pursuant to this subdivision,or�vithin five;lays o[ <br /> the date of the reques[,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comp!y�vith the request <br /> within that[ime,he shall so iniorm the individual,and may have an additional five days«�idtin which to complywith the request,excluding SaturdaYs, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure wheo daca is not accurate or complete. An individual may contest the accuracy or comple[eness ofpublic or private data <br /> concerning himsel£ To exercise[his right,an individual sha!1 notify in wiiting[he responsiblz authonty descnbing the nature of[he disagreement.The <br /> responsible authoriry shall wi:hin 30 days either: (a)con'ect the data found ro be inaccura[e or incomple�z and at[empt to notify pasc recipients o` <br /> inaccurate or incomplete data,including recipients named by[he individual;or(b)notify the individual!hat he betieves the data to be cocrect. Data in <br /> dispute shall be disclosed only if the individual's statement of disa�ceement is includzd with thz disclosed data. <br /> The determinadon of[he responsible zuthority may be appealed pursuan�to[hz provisions of the administra�ive procedure act rela[ing to <br /> contested cases. <br /> DATA PRIVACY AD`'ISORY <br /> In accordance�vith M.S. 13.04,Subd.2;"Rights of sub}ects oi data",we would like to infom you that your request <br /> for a permit or license from the City of Orono or any oi its departments may require you to fumish certain pnvate or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to deterrnine your qualifcation for the pernzit or licease <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City den_y the pe:mit or Iicense. <br /> ti. The infor.mation may be sha-ed with other local, state or federal a�encies to the extent necessary to <br /> process the perniit or license. <br /> 4. If vour;•equested permit or license requires Council actior.to approve, some infomlation rnay become <br /> nublic. <br /> �. You have certain rignts under M.S. 13.04(zvailable upon request) to revie�v private data on yourset.`. <br /> 6. Your full nam�is required to process this appiication or permit. <br /> 'First ltiliddle Last <br /> Address <br /> C�h, State Zip Phone <br /> i understand m�� rights as stated above. <br /> Signature <br /> 32 <br />