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r <br /> Sec.13.04 RIGHTS OF SUBJECTS 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 /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himself <br /> shall be informed of: (a)the purpose and intended use of the requesred data within rhe collecting state agency,po(itical subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or <br /> refusing to supply private or co�dential dara;and(d)the idendty of other persons or endaes authorized by state or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply investigative data, pursuant ro section 13.82, subdivision 5, to a law <br /> enforcement off'icer. <br /> The commissioner of revenue mav nlace the notice required under this subdivision in the individual income tax or oropertv 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 whether he is the <br /> subject of stored data on individuals,and whether it is classified as public,private or confidentiaL Upon his further request, an individual who <br /> is the'subject of stored private or public data on individuals sha(1 be shown the data without any charge to him and, 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 months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been <br /> collected or creared. The responsible authority 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 actuai costs of making,certifying,and compiling the copies. <br /> The responsible authoriry 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 Sa[urdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with <br /> the request within that time, he shall so inform the individual, and may have an additional 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 completeness of public or <br /> private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the na[ure of the <br /> disagreement. The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify <br /> past recipiencs of inaccurate or incomplete 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 disdosed orily if the individual's statement of disagreement is included with the disclosed data. <br /> The detennination of the responsible authority may be appealed pursuant to the provisions of the administrative 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 City 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 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 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 pernut 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. You�full name is required to process this application or per ' . <br /> � /� , �� <br /> f,2 G <br /> First Middle Last <br /> �-�"��C7 �''11�t' � ��� ���`��- <br /> Address <br /> ',��� �`� i'�I�-r-r� `� S ,��� .���'�S C�� <br /> Ciry State Zip Phone <br /> I understand my rights as t �bove. <br /> G�� �� �� <br /> Signature <br /> 6 <br />