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Sec.13.04 RIGHTSOFSUBJECTSOFDATA <br /> , Subdivisron 1. Type ojdata. The rrghts oJindividual on whom the data is stored or to be stored shal!be as set forth in thrs section. <br /> Subd.2. lnjormation required to be given individuaG An indrvidual asked to supply private or confrdentral data concerning himself <br /> shall be informed oj.• (a)the purpose and intended use of the requested data wrthin the collecting state agency,polrtical subdivision,or statewide <br /> system;(b)whether he may rejuse or is lega[ly required to supply the requested data;(c)arry/rnown consequence arising jrom his supplyrng or <br /> refusing lo supply private or confrdential data;and(d)the identity oJother persons or entities authorrzed by state orfederal!mv to receive the data. <br /> Thrs requirement shall not apply when an indrviduaf rs asked to supply investrgative data,pursuant to section 13.82, subdivrsion 5, to a lmv <br /> enforcement officer. <br /> The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or property tax rejund <br /> instructrons instead ofon those forms. <br /> Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shal!be informed whether he is the subject <br /> ojstored data on indivrduals, and whether it is classifted as public,private or conf dential. Upon his further request,an individual who is the <br /> subject of stored private or public data on rndivrduals shal!be shown the data wrthout any charge to him and, if he desires,shall be informed of <br /> the content and meaning oJthat data. Aj1er an individual has been shotivn the prrvate data and rnformed oJits meaning, the data need not be <br /> disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individua!has <br /> been collected or created. The responsrble authorrry sha[I provide copies oJ'the private or public data upon reguest by the individual subject of <br /> the data. The responsible authoriry may require the requesting person to pay the actua!costs of makrng,certifying,and compilrng the copies. <br /> The responsible authority shall comply immediately,ifpossible,with any request made pursuant to this subdrvision,or withinJive days <br /> oJthe date of the reguesl,excluding Saturdays,Sundays and legal holydays,if immediate complrance is not possible. Ifhe cannot comply with the <br /> request tivithrn that time,he shall so injorm the rndrvrdual,and may have an additronal five days�vithin whrch to comply�vith the request,excluding <br /> Saturdays,Sundays and legal holydays. <br /> Subd.4. Pracedure when data is not accurate or complele.An individual may contest the accuracy or completeness ofpublrc or private <br /> data concerning himself. To exercise thrs rrght, an individual shal!not�in w�iting the responsible authorrty describing lhe nature of the <br /> disagreement. The responsible authority shall ivithin 30 days erther: (a)correct the datafound to be inaccurate or rncomplete and attempt to not� <br /> past recipients of inaccurate or incomplete data,including recipients named by the indivrdual;or(b)not�the indivrdual that he belreves the data <br /> to be correct. Data rn dispute shal!be disclosed only if the individual's statement ojdisagreement is rncluded wrth the disclosed data. <br /> The determination ojthe responsible authoriry may be appealed pursuant to the provisions of the admrnrstrative procedure act relating <br /> to contested cases. <br /> DATA PRIVACYADVISORY <br /> In accordance with M.S.13.04,Subd.2, 'Rrghts ofsubjects of data';we would lrke to rnform you that your request for a permrt or license <br /> from the City of Orono or any ojits departments may require you to furnish certain private or confidential informatron. <br /> You are notified that: <br /> /. The information you furnish will be used to determrne your qua/ifrcation for the permit or license reqt�esJed. <br /> 2. You may refuse to supply data,but refusa!may requrre that the City derry the permit ar license. <br /> 3. The rnformation may be shared with other local,state or federal agencies to the extent necessary to process the permit or <br /> license. <br /> 4. I,f your requested permit or lrcense requires Council actron to approve,some informatron may become pu6lic. <br /> S. You have certain rrghts under M.S. 13.04(see followrng pageJ to revietir prrvate data on yaurselj. <br /> 6. Your full name is required to process this app/ication or permit. <br /> PLEASE PRlNT <br /> � <br /> �,c;c �v� /1����-�; <br /> First I � Middle Last <br /> � <br /> S 1���, �;� A����., ' �E� r��J1 <br /> Address <br /> vv��I�� ��,�1,� �S 3��� y��--y���-�� �� <br /> City , State Zrp Phone <br /> � � . <br /> /under.s�a ' ights as stated above. <br /> `;� �� n �- <br /> Signature,�' ��+� ����� <br /> ; 1��,,�� y.ti �t,-� ��"� <br /> �o <br />