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r . � . � <br /> r <br /> Sec.13.04 RIGHTS OF SITBJECTS 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 /> S�bd.2. Information required to be givven individual. An iodividual asked to suPP�Y Private or co�dential data conceming himself <br /> shall be informed of: (a)the purpose az�d icueaded use of the requesud data within the collecting srate agency,polidcal subdivision,or statewide <br /> sysum;(b)whether he may refuse or is legally required w supply the requested data;(c)any lrnown consequence arising from his supplying or <br /> refusing to supply private or confidential data;and(d)die idenUry of other persons or euaaes authorized by state or federal law to receive the daCa. <br /> This requirement shali not apply when an individual is asked to supply investigative data,pursuant to section 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The comm�ssioner of revern�e mav olacf the md rea�ired�nder this subdivision in the individual income taz or orocertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the <br /> subject of stored data on iidividuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who <br /> u d�e subje�t of stored private or�blic data on individuals shall be shown the data without any charge to him a�tti,if he desires,shall be informed <br /> of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six mondu thereafter unless a dispute or acdon pursuant ro d�is secaon is pending or addirional data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible audwrity shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days <br /> of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with <br /> the request within that time,he st�all so inform the i�ividual,and may have an additional five days within which to comply with the request, <br /> ezcluding Saturdays,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 <br /> private darn conceming himself. To ezercise this right,an individual shall notify in wridng the responsible authority describing the nawre of the <br /> disagreement. The responsble authoriry sl�all within 30 days either: (a)correct the data found ro be inaccurate or incompleu and attempt to notify <br /> past recipienu of inaccuraoe or incomplere data,including recipients named by the individual;or(b)notify the individual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The deternuna6on of the responsible authoriry may be appealed pursuant to the provisions of the administredve procedure act relating <br /> to 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 <br /> request for a permit or license from the �iry of Orono or any of its departments may require you to furnish certain <br /> private or confidential information. <br /> You aze notified that: <br /> 1. The information you fumish will be used to determine your qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data, but refusal may require that the Ciry 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 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 righis 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 /> �-, / <br /> ���s G�,z,y �� <br /> First Middle Last <br /> J y�0 � l Uy �� <br /> Address � <br /> C�12�v� rYl ti s�-3 g,/ �7/ -5 Z��" <br /> C�ty State Zip Phone <br /> I understand my ri ts as st ed above. <br /> Signatu <br /> 6 <br />