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� <br /> Sec.13.04 RIGHTS OF SUBJECT5 OF DATA <br /> Subd. I. Type of data. The nghts o£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 confidential data conceming himselfshall be <br /> informed of: (a)the purpose and intended use of the requested daca within the collecting scate agency,political subdivision,or statewide system;(o) <br /> whether he may refuse or is legally required to supply the requested data;(c)any kno�vn consequence arising from his supplying or refusing to supply <br /> priva[e or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuanc to section 13.32,subdivision 5,to a law enforcemen[officer. <br /> The commissioner of revenue may place the notice required under this subdivision in the individual income tax or propertv tax refimd <br /> instructions 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 subject of <br /> stored data on individuals,and whether it is classified as public,private or confidentiat. Upon his further request,an individual who is the subject of <br /> stored private or public da[a 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[hat data. After an individual has becn shown the pnvate data and informed 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 requcst by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual costs of making,ceRifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or wi[hin five days of <br /> [he date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days witltin which to comply with the request,excluding Sahtrdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accura[e or complete. An individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To exercise this right,an individual shall notify in wiiting the responsible authoiity describing the nahtre of the disagreemenc.The <br /> responsible au[hority shall within 30 days either: (a)con�ec[the data found[o be inlccura[e or incomplete and attempt to notify past recipients o(' <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be con e: ', �+i� <br /> 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 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 infoizn you that your rec�uest <br /> for a pemiit or license from the City of Orono or any of its departments may require you to fumish certain private or <br /> confidential information. r <br /> You are notified that: <br /> 1. The information you fumish will be used to determine your qualification for the pernZit 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 the extent necessary to <br /> process the pern�it or license. <br /> 4. If your requested permit or license requires Council action to approve, some infomiation may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04(available upon request) to revie�v private data on yourself. <br /> 6. Your full name is required to process this application or permit, <br /> �-��� � �Nt���c.i' g� � <br /> First N[iddle Last <br /> �y �� ss� sf- � w g�lo <br /> Ad ress <br /> I7J��,L� (� � 5��� �lil�� �c��d7 <br /> City State Zip Phone <br /> I underst d m rights as stated above. <br /> 5ignature <br /> 32 <br />