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J <br /> Sec.13.0�J RIGHTS OF SUBJECTS OF DAT:1 <br /> Subd. 1. Type of data. The rights of individual on whom the data is srored or to be stored shall be as set forth in this section. <br /> Subd.2. Infonnation 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 ofthe requested data within the collecting sta[e agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legal ly required to supply the requested data;(c)any known consequence arisin�from his supplyin�or refusing to supply <br /> pnvate or confidential data;and(d)the identity ofother persons or entities authorized by state or federai law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement ofticer. <br /> The commissioner of revenue may_place the notice required under this subdivision in the individual income tax or propertv tax refund <br /> instruc[ions instead of on those fonns. <br /> Subd.3. Access to data by ittdividual. 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 contidential. Upon his fuRher request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown d�e data without any charge to him and,if he desires,shali be informed of the content 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 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 request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person ro pay the actual costs of making,certifying,and compiling Ihe copies. <br /> l'he responsible aud�ority shal I comply immediately,if possible,�vith any request made pursuant to this subdivision,or wi[hin tive days of <br /> the date ofthe request,escluding Saturdays,Sundays aitd legal holidays,if immediate compliance is not possible. If he cannot comply�vith the request <br /> �vithin that time,he shall so inform the individual,and may have an additional tive days within which to comply with the reques[,excluding Saturdays, <br /> 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 priva[e data <br /> concerning himself. To excrcise this right,an individua(shall notify in writing the responsible authoriry describing the nature oY the disaereement. The <br /> responsible authoriry shall�vithin 30 days either (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,induding recipients named by the individual;or(b)notity the individual that he believes the data to be correct Data in <br /> disp�!t?sLal!be disclnsed only if tl�e individual's sfatement of disagreement is induded w'ith 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 inform you that your request <br /> for a pern�it 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 detennine 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 pennit or(icense. <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 rec�uested permit 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 permit. <br /> First Nliddle Last <br /> :lddress <br /> Cih� State Zip Phone <br /> I understand my rights as stated above. <br /> ���%�' ���..�5<%�"'`t-f <br /> Sign��ture <br /> Reset Form �=' <br />