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Sec.13.04 RIGHTS OF SUBJEC'I'S 0['DATA <br /> Subd.1. 7'ype ot data. Thc rights of individual on whom thc data is stored or to be stored shull be as set forth in this section. <br /> Subd.1. Information requL�cd to be given individual. An individual asked to supply privnte or conlidential data concerning himsellshall be <br /> informed oL• (a)the purpose and intended use of thc requested data within the coliccting state agenc}',political subdivision,or statewide system;(b) <br /> �rhether he may refuse or is Iegally reryuired to supply thc requested data;(c)an��known consequence arising trom his supplying or refusing to supply <br /> privatc or confidcntial data;and(d)thc identity of othcr persons or entities authorized by state or fedcral la�v to receive the data. This requirement shail <br /> not apply�vhen an indi��idual is askcd to suppl}�im�esligative data,pursuant to section 13.82,subdivision 5,to a law en(orccment of(icer. <br /> The commissioner o[revenue mav olace the notice reauired under this subdivision in the individual income tax or nropertv tnx refund <br /> instructio�is instead of on those torms. <br /> Subd.3. Access to data by individuaL Upon request to a responsible nuthorily,an individual shall be informed whether he is the subJect of <br /> stored data on individuals,and whether it is classifed as public,private or conOdential. Upon his further request,nn individual who is the subJect oC <br /> stored privatc or public data on individuals shall bc sho�rn the datn without nny cl�arge to him and,(f he desires,shall be informed of the content and <br /> mcaning of that data. Aftcr an individual has been shown the private dntn and informed of its mcaning,the datn necd not be disclosed to him for six <br /> months thercafter 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 prirate or public datn upon request by the individual subJect of the data. The responsible authority may <br /> rcquirc the rcqucsting person to pay thc actual costs of making,certifying,and compfling thc copics. <br /> Thc responsible nuHiorily shall comply immediately,i(possiblc,�vith any requcst made pursuant to this subdivision,or within(ive days of the <br /> da[c of the request,escluding Saturdays,Sundays and Iegal holidays,iC immediate compliance is not possiblc. I(hc ca�uiot comply with the request within <br /> that time,he sliall so inforn�the individual,and�nay have an additional fi��e days within whic6 to comply with the requcst,excluding Saturduys,Sundays <br /> and Icgal holidays. <br /> Subd.4. Proccdurc when dnta is not uccurafe or complete. An individual tnay contest tlie accuracy or completeness of public or prtvate data <br /> concerning himsclf. To esercisc lhis right,an indivWunl shall notify in writing the responsible nuthority describing the nature o(tl�e disagreement. The <br /> responsible authority shall within 30 Jays eithe�: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccm�ate or incomplete data,including recipients named by the individual;or(b)notify the individual lhat he believes the da(a to be correct. Data in <br /> dispute shall bc discloscd only i(the individuul's statement of disagrcement is included wlth tlie disclosed datn. <br /> Thc dctermination of thc responsiblc authority may bc appcaled pursuant to thc provisions of thc adminish•ative procedurc nct rclating to <br /> contestcd cascs. <br /> DATA PRIVACY ADVISORY <br /> Li 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 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 notificd that: <br /> 1. The inlormation you furnisli will be used to determine your qualification for the permit or license requested. <br /> 2. You may refuse to supply data,but refusal may require tliat 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 process <br /> the permit or license. <br /> 4. If your requested permit or liceiise requires Council action to approve, some information may beco�ue <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 tl�is application or permit. <br /> �e�w �.�-.,��,� �,�..� <br /> Pirst Middle Last <br /> C )�"I� L�I "S`"C�CriL.—c.J ��—�r <br /> Address <br /> �' V�`� _ \� 1� S'J�3ro� Cot 2 ���—SSl� <br />� Cit State Zip Phone <br /> I un � iy r gh as a d - <br /> � <br /> � <br /> � Signature <br /> . ' <br />