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Sec.13.04 RIGHTS OF SL3BJECTS OF DATA <br /> Subd.1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set farth in this section. <br /> Subd.2. [nformation required to be given individual. An individuat asked to suppiy private or confidential data conceming himself shall be <br /> informed of (a)the pia�pose and intended use ofthe requested data within the coliecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to suppty the requested data;(c)azry known consequence arising from his suppiying or refusing to supply <br /> private or confidernial data;and(d)the idecrtity of other persons or entiares authorized by state or federal law to receive the data.This requirement shall <br /> not apply when an individual is asked to suppfy investigative data,pucsuant to section 13.82,subdivision 5,to a Iaw enforcemeni officer. <br /> The commissioner of revenue mayplace the notice required under this subdivision in the individual income tax or prooertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsib(e authority,an individual shatl be infoaned whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or wnfidendaL Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without arry charge to him and,if he desires,shall be informed of the 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 six <br /> months thereafter�mless a dispute or action pursuant to this section is pending or additional data on the individual has been co(leeted ar created.T'he <br /> responsible authority shall provide copies of the private or public data upcm request by the individual subject of the daffi The respomcible authority <br /> may require the requesting person to pay the actual costs ofmaking,certifying,and compili�the copies. <br /> The responsible authority shall comply immediateiy,if possible,with azry request made p�usuanf ta tlus subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and le�l hol idays,if immediate compliance is not possible. if he cannot comply with the request <br /> within that time,he shall so inform the individual,ar�d may have an additiona(five days within which W comply with the request,excluding Satiudays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accivate or complete. An individual may corrtest the acc�acy or ccxnpfeteness of pubi ic or private data <br /> conceming himself.To exercise this right,an individual shail notify in writing the responsibie authority descnbing the nature ofthe disagreemern The <br /> responsible authority shall within 30 days either. (a)correct the data fowid to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the ir�dividual;or(b)notify the ir�dividual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the icidividual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to ihe provisions of the administrative procedure act rela[ing 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 <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the permit or Iicense. <br /> 3. The information may be shazed 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 rights under M.S. 13.04(available upon request)to review private data on yourseIf. <br /> 6. Your full name is required to process this application or permit. <br /> 4eker j��, � SQz� � <br /> First Middle Last <br /> �5 3 r ��� � I . <br /> Address <br /> C> rcS� J ,.< <., S��39 I �/�2 , 4� ! I t 4� <br /> Crty State Zip Phone <br /> I understand my rights as stated v <br /> , " � L <br /> Siguature <br /> Reset Form 32 <br />