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Sec.13.04 RIGA7'S OF SUBIECTS OF DATA <br /> Subd.1. Type of data. The rights of individual on whom the data is stoied or to be stored shall be as set forth in this section. <br /> Subd.2 Information required to be given individual.An irdividual asked to supply private or confidenlial data conceming himself shall be <br /> informed 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)atry known co�sequence arising from his supplying or refusing to supply <br /> private or confideMial data;and(d)the iderrtity of ott�er persons or eMities authorizad by state or federal law to receive the data This requirement shall <br /> not apply when an individual is asked to suppiy investigative data,pusuant to section 13.82,subdivision 5,to a law enforce�otTicer. <br /> The cortmussioner of reven�mav olace the notice reguired w�der t6is subdivision in the ird�h�l mcome tmc or prop�rty ta�c refund <br /> instructions inslead of on those forn�s. <br /> Subd.3. Access to data by individual. Upon request to a responsible authorily,an individual shal I be infom�ed whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or confidential. Upon his fiuther request,an individual who is the subject of <br /> stored private or public data on individuals st�all be shown the data without any charge to him and,if he desires,shall be infonned of the corrtent and <br /> meaning of that data. After an individual has been shown the private dafa and infom�ed of its meaning,the data need not be disclosed to him for six <br /> months thereafter wiless a dispute or action p�ssu�N to this section is pendi�or additional d�a on the individual has been cdlected or aeated. The <br /> responsible authoriry shall provide copies of the privale or public d�a►q�on request by the individual subject of the d� The msponsible authority <br /> �Y re9��R4���8 Perso�to pay the achml costs of maki�g,certifying,and compilmg U�e copies. <br /> The respo�ible authority shall cor�►ly inenediately,if possible,with a�ry request nrede piasuant to this subdivision,or within five days of <br /> the date of the request,e�ccluding Sahudays,Sundays and legal holidays,if i�iate compliance is not possible.If he qnrat ca�ly with the request <br /> within that time,he st�all so inform the iudividual,and may have an additional five days widtit�which W comply with the reqtest,excludi�Saturdays, <br /> Sundays and le�l holidays. <br /> Subd.4. Procediue when data is not ace�te or complete.An udividual umy cmtest the aoc�racy or canplete�c�ofpuMic or private data <br /> conceming himselE To e�cercise this rigtrt,an individual shall ndify in wriling the resportsible aWhai(y de.scn'bingU�e r�e of'the d��nent T}�e <br /> responsible authority shall within 30 days either. (a)correct the dala found to be iaacauate or incomplete and attempt 10 notify pest recipients of <br /> inaccurate or incomplete dat�includi�recipients�med by ihe individual;ar(b)notify t6e mdividuel t6et he believes the�a to be correct. Data in <br /> dispute shall be disclosed only if the individual's stafemem of disagreement is included with the disclosed data <br /> The detecmination of the responsible autt�ority may be appealed piusuant to tlie provisions of the admioistrative procedure xt 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 yow request <br /> for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> 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 other local, state or federal agencies to the extent necessary to <br /> process the permit or license. <br /> 4. If your requested pennit 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 petmit. <br /> �� �n-.�1 � J.. ���..� � r �Y'., <br /> First Middk Lut <br /> � l��`] l�`� I�- , c�`1/Q �2 �� <br /> Addreac ' <br /> �; � � �.; r.:� S h 3 s � C l2 - �',�'�. ��,> � <br /> c��y snu z� �� <br /> I understand my rights as stated above. <br /> ` ��?�,,— '� i �ZC��„-7 <br /> Signature <br /> Reset Form 32 <br />