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1 <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.1. Type o[data. The rights of individual on w kum t�e data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. In[ormation required to be gi�en individual_�n in.3i�-idual asked to supply private or confidential data concerning himself shall be <br /> informed of: (a)the purpose and intended use of the requested iata within the collecting state agency,potitical subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requesed dua;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity o[other persons:r ent�ies authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an indicidual is asked to supply iorestigative d�pursnant to section 13.82,subdivision 5,to a law en[orcement officer. <br /> The commissioner o[revenue mav place the notice reuuire� under this subdivision in the indicidual income tax or orooertv tar refund <br /> instructions mstead of on those forms. <br /> Subd.3. Access to data by individuaL Cpon request�a rexponsible authority,an individua!s6a11 be informed whether he is the subject of <br /> stored data on individuals,and whether it is classified as publie pri�arr or conFdential. Upon his further request,an individual who is the subject of <br /> stored private or public data oo individuais shall be shown the�ta wffihout any charge to him and,if he desires,shall be informed of the content and <br /> meaning of that data. After an individual has been shown the Frivate data and in[ormed of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this secoo is pending or additional data on the indi�•idual has been collected or created. The <br /> responsible authority shall pro�-ide copies of the pri�ate or public,iata apon request by the individual subject of the data. The responsible authority may <br /> require the requesting person to pay the actual costs of making.srtif.�ins,and compiling the copies. <br /> The responsible authority shall comph immediatei}',if possit�3e,with any request made pursuant to this subdivision,or within fi�•e days of the <br /> date of the request,excluding Saturdays,Sunda}s and legal holidiys,if immediate compliance is not possible. If he cannot comply with the request wi[hin <br /> that time,he shall so inform the individual,and ma}have an add:ional 5ce days within which to comply with the request,excluding Saturdays,Sundays <br /> and legal holidays. <br /> Subd.4. Procedure when data is not accurate or com�(ete. �n individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To esercise this right,an indi�idual shall nor.fr�in.�riting the responsible authority describing the nature of the disagreement. The <br /> responsible authority shall within 30 days either. (a)correct c:a data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by t6t indi�i�3ua1;or(b)notify the individual that he believes the data to be correcL Data in <br /> dispute shall be disclosed only if the individual's statement of div�ree�ent is included with the disclosed data. <br /> The determination of the responsible authority mac te appraled pursuant to the provisions of t6e administrative procedure act relating to <br /> contested cases. <br /> DAT�PRI�=�CY ADVISORY <br /> In accordance with`i.S.13.04,Subd.2,"RighU of subjects of data",we would like to inform you that your request <br /> for a permit or licease from the City of Orono or an�-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 u�d to determine your qualificarion for the permit or license requested. <br /> 2. You may refuse to suppl�-data,but rfusal may require that the City deny the permit or license. <br /> 3. The information may be shared with other�ocal,state or federal agencies to the extent necessary to process <br /> the permit or license. <br /> 4. If your requested permit or license rz�uires Council action to appro��e, some information may become <br /> public. <br /> 5. You have certain rights under 1�I.S. 1:.0�3 �a�-ailable upon request) to re�zew private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> Q ` <br /> ^�,w �/�^;q�� <br /> F�rst �Lddle La <br /> �77�� 1 ni�l�^��'�✓ G1lG� � � <br /> Address <br /> �s�,�,� n�l�� �SC��C� 76 � W�1�{ 5 ���. <br /> City State Zip Phone <br /> I understand my rights as stated above. . <br /> , <br /> Signature <br />