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�#� <br /> ' � 4 <br /> Sec.13.04 RIGH'I'S OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights 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 confidenrial data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or <br /> refusing to suppty private or confidendal data;and(d)the idenary of other persons or entides authorized by srate or federal law to receive the data. <br /> This requireme�t shall not apply when an individual is asked to supply investigative data, pursuant to sectio❑ 13.82, subdivision 5, to a law <br /> enforcement o�cer. <br /> The commissioner of revenue mav nlace the norice reouired under this subdivision in the individual income tax or orooertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,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 co�dentiaL Upon his further request, an individual who <br /> is the subject of stored private or pubiic data on individuals shall be shown the data without any charge to him and, if he desires, shall be infornted <br /> of the con[ent 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 secdon is pending or additional data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or pubiic data upon request by the individual subject of the data. <br /> The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply unmediately,if possib(e,with any request made pursuant to this subdivision,or within five days <br /> of the date of the request,excluding Saturdays,Sundays and legal 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 additional five days within which to comply with the request, <br /> excluding 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 data conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the <br /> disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt ro notify <br /> past recipients of inaccurate or incomplete daha,induding recipients named by the individual;or(b)notify the individual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinabon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relaung <br /> to 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 <br /> request for a permit or license from the �ity 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 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 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 Middle Last <br /> Address <br /> ' Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> Signature �• <br /> 6 <br />