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, � <br /> � <br /> Sec.13.04 RIGHTS OF Si1BJECTS OF DATA <br /> Subd. 1. Type of data. The righcs of individual on whom che data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Informatioa reqirired to be givea individual. An individuai asked to supply private or confidendal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecting�tate agency,poliacal subdivision,or sratewide system; <br /> (b)whether he may refuse oY is legally required co supply the requested data;(c)any irnown consequence arising from his supplying or refusing to supply <br /> private or confidendal data;and(d)the idenriry of ocher persons or entides auchorized by sta[e or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesd¢adve data, pursuant to secdon 13.82, subdivision 5,to a law enforeement ofFcer. <br /> The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or propertv tax refund <br /> instructions inscead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individua(shall be informed whether he is tt►e subject <br /> of storod data on individuals,and whether it is classified as public, priva[e or confidenual. Upon ivs further request,an individual who is the subject <br /> of stored private or public data on individuats shall be shown the data wichout any charge to him and,-if he desires, shall be informed of the content <br /> and meaning of[hat data. After an individual has been shown che private daca and informed of its meaning,the data need not be disclosed to him for <br /> siz months thereafter unless a dispute or acdon pursuanc to this secrion is pending or addidonal data on che individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual 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 of <br /> the date of the cequest,excluding Satutdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> wi[hin that time,he shall so inform[he individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays, <br /> 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 private <br /> data concerning himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsibte au[hority shall within 30 days ei[her: (a)correcc rhe data found to be inaccurate or incomplete and attempt to norify past recipients of <br /> inaccunte or incomplete data, including recipients named by the individual;or(b)nodfy the individual that he believes[he data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disciosed data. <br /> The determinarion of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relating 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 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 license 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 process <br /> the pemut 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 /> /�!�►Zl�- � . GA-S�h <br /> First Middle Last C7 <br /> d s �-A��on� /�2�v� <br /> Address � <br /> O✓c.a,c�� /y(,s� cc�cc„ y7�-�73 S <br /> City Stace Zip Phone <br /> I understand my rights as stated above. <br /> Signa re <br />