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Sec.13.04 RIGHTS OF SIJBdECTS OF DATA r � <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 secdon. <br /> Subd.2. Information reqirired to be given individual. An individuai asked ro supply private or confidenaal data conceming,himself <br /> shall be informed of: (a)the purpose and in[ended use of the requested data wichin the collecdng state agency,polidca!subdivision,or statewide <br /> rystem;(b)whether he may refuse or is legally required ro suppty the requested data;(c)any lrnown consequeace arising from his supplying or <br /> refusing m supply privam or confidential dara;and(d)the idenriry of other persons or enades authorized by sare or federal law to receive die data. <br /> This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secdon 13.82, subdivision 5, to a law <br /> enforcement o�cer. <br /> 'Rie commissioner of revenue mav olace the notice reauired under this�ibdivision in the individual income raz or nroeertv tax refund <br /> instrucrions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request W a responsibie auchority,an individual shall be informed whether he is die <br /> svbject of stored data on individuals,and whether it is classified as public,private or co�dendal. Upon his further reques�an individual who <br /> is the subject of stored private or public data on individuals shall be shown the dara without any charge to him and,if he desires,shall be informed <br /> of the content and meaning of that data. Aher an individual has been shown the private data and informed of iu meaning,the data need not be <br /> disclosed to him for six months thereafcer unless a dispure or acaon pursuant to this secaon is pending or addirionat data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or pub(ic dara upon request by the individual subject of the data. <br /> The responsible auchority may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediacely,if possible,with any request made pursuant to this subdivision,or within five days <br /> of the dace of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compiy with <br /> the request within that ume,he shall so inform the individual,and may have an addidonal five days within which to comply with the request. <br /> excluding Saturdays,Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compieteness of public or <br /> priva�e data conceming himself. To exeroise this right,an ic�ividual shaii notify in writing the responsible authoriry describing the nawre of the <br /> disagreemenG The responsible authoriry shall within 30 days either: (a)correct the daa found to be��a�M��te or incomplete and attempt to nodfy <br /> past recipients of inaccura[e or incomplete data,inctuding recipientc nacned by the individual;or(b)noafy the individual that he believes the daa <br /> to be correct. Data in dispute shall be disclosed only if the individual's sratement of disagreement is included with the disciosed dara. <br /> The deternunaaon of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act reladng <br /> m 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 �ity of Orono or any of its departments may require you to furnish certain <br /> private or confidential information. <br /> You are 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 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 <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 yourself. <br /> 6. Your full name is required to process this application or permit. <br /> ��� �'��- IQoc.� �o�'►n 5�.�- <br /> First Middle Last <br /> � � �% f/b i�r LcJ O GY'�/ �-.� <br /> Address <br /> �Io�� vh n� ss-�6 y ��.-��s— <br /> C��Y Srate Zip Phone <br /> I understand my rights ate above. <br /> � <br /> � <br /> Sig mre <br /> 6 <br />