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� <br /> Sec.13.04 RIGH'TS OF SUBJECTS OF DATa <br /> Subd. i. Type of data. The rights of individual on whom the data is scored or to be stored shall be as set forch in this secaon. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested dara within the collecting'state agency, political subdivision,or statewide system; <br />(b)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 confidendai data;and(d)the idennty of other persons or entides au[horized by state or federal law ro receive the data. This requirement shall <br /> no[apply when an individual is asked to supply invesrigadve data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue mav place the nodce reauired under this subdivision in the individuai income tax or proper[v tax refund <br /> instructions inscead of on chose forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals, and wherher it is classified as public, private or confidendal. Upon his furthet request, an individual who is the subject <br /> of stored private or public data on individuals shall be shown che data wichout any charge to hirn and, if he desires, shall be informed of the content <br /> and meaning of[hat data. Afrer an individual has been shown the private data and informed of iu meaning,che data need not be disclosed to him for <br /> six months thereafter unless a dispute or acaon pursuan[co this sec[ion is pending or addidonal data on the individual has been collected or created. <br /> The responsible auchority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual costs of makin¢, certifying, and compiling the copies. <br /> The responsible authority shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of <br /> the date of the requesc,excluding Sacurdays,Sundays and leeal holidays,if immediate compliance is not possible. If he cannoc comply with the request <br /> within that time,he shall so inform che individual,and may have an additional five days within which to comply with the requesc,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private <br /> data conceming himself. To exercise this rieht,an individual shall nodfy in wri[ing the responsible authority describing the narure of[he disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, including recipients named by che individual; or(b)notify the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's stacement of disagreement is included with the disclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act reladng 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 /> 1. The information you furnish 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 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 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 M.S. 13.04 (available upon request) to review private data on yourself. <br /> (. Your full name is required to process this application or permit. <br /> �R U�r= i�r f_, �, ,. <br /> First Middle Lasc <br /> `���f� l-� � 'j� �, <br /> Addre{ss � � �c ?i . , ��—, 1 � ��� <br /> I \ V���t l._?� y r1� �, �—�-� x_� � � /�t L � <br /> Ciry State Zip Phone <br /> I underst�d my�'ights as stated abAve. <br /> !� � <br /> i� /� <br /> � �� ;, �-;"� <� '���' � <br /> Signature <br /> i . <br />