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r. ' ' <br /> Sec.13.04 RIGHTS OF SUBJECTS OF D�TA <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 indi��dual asked to supply private or confidenUal data concerning himself shall be <br /> informed oL• (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide rystem;(b) <br /> whether he may refuse or is legally required to supp)y the requested data;(c)any know n conseque�ce arising from his suppkin;or refusing to supph- <br /> private or confidential data;and(d)the identity oCother persons or entities authorized by state or federal law to receire the data. This requirement shall <br /> not appiy when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav lace the notice re uired under this subdivision in the individual income tax or ro ertv tai refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. lipon request to a respoosible 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 rnnfidential. Upon 6is further request,an indir•idual N ho is the subject of <br /> stored private or public data on individuais shall be shown the data without any cha se to him and,if he desires,s6a11 be in(ormed of the content and <br /> meaning of that data. After an individual has beeu shown the private data and informed oC its meaning,the data need not be disclosed to him[or 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 shail provide copies of the private or pubiic data upon request b}•the individual subject of the data. T6e responsible wthorih�mav <br /> require the requesting person to pay the actual costs of making,certifying,and compiling the copies. • - <br /> The responsible authority shall comply immediately,if possibie,with any request made pursuant to this subdivision,or w ithin fn•e days of the <br /> date o[the request,excluding Saturdays,Sundays and legal holidays,i[immediate compliance is not possible. If he can�ot compk with the requestNithin <br /> that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,Sundacs <br /> and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeoess of public or private data <br /> concerning himselL To exercise this right,an individual shall notify in writing the responsible aut6ority describing the nature of the disas.reement.The <br /> responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete aod attempt to�otify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct Data in <br /> dispute shall be disclosed only if the individual's statement oCdisagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrati�e procedure act relating to <br /> contested cases. <br /> D:�TA PRIVACY AD�TSORY <br /> In accordance with 1�I.S.13.04,Subd.2, "Rights of subjects of data",we would like to inform you that�-our 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 /> conFdential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine�-our qualification for the permit or license 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 estent necessar�-to process <br /> 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 i�I.S. 13.04 (a�•ailable upon request) to review private data on�•ourself. <br /> 6• Your full name is required to process this application or permit. <br /> First Middle <br /> Last <br /> Address <br /> C�ty State <br /> Z�P Phone <br /> I understand my rights�as stated above. <br /> � <br /> i r � <br /> : ';,?-7`� <br /> ,2�J r�� <br /> Signature <br />