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Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.1. Type of data. The righcs of individual on whom[he dlta 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 of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,orstatewide 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 identiry of other persons or entities authorized by state or federal law to receive the data.This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.32,subdivision 5,to a law enforcement officer, <br /> The comm�ssioner of revenue mav ntace the notice requ�',red under this subdivision in the individual income taY or nronertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual.Upon request to a responsible authoriry,an individual shall be informed�vhether he is the subject of <br /> stored data on individuals,.and whether it is classified as public,private or confidential. Upon his further ceques[,an individual who is the subject oi <br /> stored private or public data on individuals sha[t be sho�vn the data without any charge to him and,if he desires,shall be informed of the concent and <br /> meaning of that data. After an individual has been sho�vn the private data 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 subjec[of the data. The responsible authority <br /> may requit�e the requesting person to pay the actval costs ofmaking,certifying,and compiling the copias. <br /> The responsible authority shail comply immediately,ifpossible,with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,e�cluding 5aturdays,Sundays and legal holidays,if immediate complianca is not possible.If he cannot compty with the request <br /> within that time,he shall so inform the individual,and may have an additional five days widiin which to comply with the request,excluding Sacurdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure whe�data is not accurate or complete.An individual may contes[the accuracy or completeness of public or private data <br /> conceming himself.To exercise this right,an individual shall no[ify in writing the responsible authority describing the naturo of the disagreement.The <br /> responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attemp[to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by che individual;or(b)notify the individual that he believes the daca to be correct.Data in <br /> dispu[e shall be disclosed only if the individual's statPment of disagreement is included wich the disclosed data. <br /> The determination of che responsible authoriry may be appealed pursuanc to[he provisions of the administ�ative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S.13.04,Subd.2,"Rights of subj ects of data",we would like to inform you that your request <br /> for a pemiit or license&om the City of Orono or any of its departments may require you to fumish 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 liceas� <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 infortnation 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 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 /> 6. Your full name is required to process this application or permit, <br /> ��, 5� . 51 l�l.. ��t� <br /> First Nliddle Last <br /> �.&� � o��� • <br /> Address <br /> � 5�5� I <br /> C��, State Zip Phone <br /> I under y rights as stated above. <br /> A C / <br /> � Y � <br /> Signature <br /> 32 <br />