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Sec.13.04 RIGHTS 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 confidential data conceming himself shall be <br /> informed oE (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shal) <br /> not apply when an individual is asked to supply investigative da[a,pursuant to sec[ion 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propertv ta�c refund <br /> instructions instead of on[hose fortns. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whethec it is classified as public,private or confidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of flte content and <br /> meaning of that data. After an individual has been shown the private da[a 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 to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,ifpossible,with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> witlun that time,he shall so inforra the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal hoJidays. <br /> Subd.4. Procedure when data is not accucate or complete. An individual may contest the accuracy or completeness ofpublic or private data <br /> concerning himself.To exercise this righy an individual shall notify in wridng the responsible authority describing the nature of the disagreement.The <br /> responsible authority shall within 30 days either. (a)correct the data found to be inacwrate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes t6e data to be correct.Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with 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 permit or license from the City of Orono or any of its depariments may require you to furnish certain private or <br /> confidenrial informarion. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the pernut or license <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the pernut 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 acrion to approve, some informarion 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 applicarion or permit. <br /> First Middle Last <br /> .�/'7 �.i.�Bfj F,r e C-cll�afJ�II/y <br /> Address <br /> ,�'J/ f.�c.�� �a �`i7G, l/y�� �f/�' �� .S"S��,S <br /> City State Zip Phone <br /> I understand my rights as stated above. <br /> Signature <br /> 32 <br />