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. <br /> Sec.13A4 RIGHTS OF SUBJECZ'S OF DATA ' <br /> Subd. L "Cype of data. The rights of individual on���hom the data is stored 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 orcontidential dataconcerning himselfshall be <br /> informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or state�vide system,(b) <br /> whether he may refuse or is le�,ally required to supply the requested data;(c)airy known consequence arising from his supplying or reFusing to supply <br /> private or confidential data.and(d)the identiry of other persons or entities authorized by state or federal law to receive the data. This requirement shal I <br /> not apply when an individual is asked to supply investieative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue may�lace die notice rec�iired under this subdivision in the individual income ta�or orooerri�tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request ro a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and��hether it is classitied as public,private or contidential. Upon his ftirther request,an individu�l�vho is the subject of <br /> stored private or public data on individuals shall be shown the data widiout any charge to him and,if he desires,shall be informed ofthe 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 si� <br /> months fhereafter 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 audiority <br /> may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with airy request made pursuant to this subdivision,or�vithin tive days ot' <br /> the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request <br /> �vithin that time,he shall so inform the individual,and may have an additional tive days within�vhich to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> S ubd.4. Procedure�vhen data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To exercise chis right,an individual shall notily in writing the responsible authori[y describing the nature of die disagreement. The <br /> responsibic authority shall within 30 days eithec (a)correct the data foimd to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or ii�complete data,including recipients named by the individual;or(b)notify the individual d�at he believes the data to be correct. Data in <br /> dispute shall be disclosed only iftlie individual's statement of disagreement is included wi[h 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 departments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> l. The information you furnish wil( be used to detern�ine your qua(ification 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 pernlit or license. <br /> 4. [f your requested permit or license requires Council action to approve, some infornlation 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 /> r���2/�r�.P �'h��e S 2 �����-�-� <br /> First J'[iddlc LHst <br /> J�� �I�a Cl���,���1 ��� ( � <br /> Address <br /> C� ���nc� M n � S�5� 9�� �'T� �a�� <br /> Citv State Zip Phone <br /> I understand my riglits as stated above. <br /> � �;Jv c-('.�/Cr <br /> Sign;�turc <br /> Reset Form �� � <br />