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� <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> , <br /> Subd. 1. Type of data. The righu 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. An individual asked to supply private or co�den[ial data concerning himself �� <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecdng state agency,polidcal subdivision, or stacewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data; (c)any laown consequence arising from his supplying or <br /> refusing to supply private or confidenaal dara;and(d)the idenriry of o�her persons or enaaes authorized by srate or federai law to receive the dan. <br /> This requiremen[ shall not apply when an individual is asked to supply investigative data, pursuant to secrion 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income taz or orocertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsibie 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 confidenrial. Upon his further request,an individual who <br /> is the subject of stored private or public dara on individuals shall be shown the data without any char;e[o him and, if he desires, shall be informed <br /> of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six months thereafter unless a dispute or acdon pursuant to this secoon is pending or addidonal data on the individual has been <br /> coflected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible auchoriry may require the requesring person to pay the actual costs of making,cercifying,and compiling the copies. <br /> 'Ihe responsible authoriry shall comply immediacely,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 legaf holidays,if immediate compliance is not possible. If he cannot comply with <br /> the request within that time, he shall so inform the individual,and may have an addidonal five days within which to comply wirh the request, <br /> excfuding 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 da[a concerning himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the�ature of the <br /> disagreement. The responsibfe authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nocify <br /> past recipients of inaccurate or incomptete dara,including recipienu named by the individual;or(b)nodfy the individual that he believes the data <br /> co be correct. Data in dispute shall be disciosed only if the individual's statement of disagreement is included with the disclosed dara. <br /> The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminis�aave procedure act relatin� <br /> to contested cases. <br /> D�TA 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 <br /> request for a permit or license from the City 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 m3y 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 the extent necessary to <br /> process the permit or license. <br /> 4. If your requested pernut or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain riehts 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 /> � <br /> .� , <br /> � � <br /> i ' <br /> First bfiddle <br /> _��� � Last <br /> .�` C l C.,�� � <br /> ��,� i� � t��'��= ����� Z� <br /> C�ry Srate Zip Phone <br /> I understand my rights as stated abov . <br /> i� �� `�� <br /> si;nature <br /> 6 <br />