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� ' <br /> Sec.13.04 RIGH'I'S OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom[he data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidenaal data conceming himself shall <br /> be informed of: (a)the purpose and intended use of the requested data wi[hin the collecdng'stace ageocy, poliacal subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requestzd data;(c)any Imown consequence arising from his supplying or refusing to suppty <br /> privace or confidendal data;and(d)the idenriry of other penons or enddes auehorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrigauve data, pursuan[to secaon 13.82, subdivision 5, co a law enforcement officer. <br /> The commissioner of revenue ma� place the notice required under this subdivision in the individual income tax or propertv tax refund <br /> instrucdons instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whethet he is[he subject <br /> of stored data on individuals, and whecher it is classified as public, privaee or co�dential. Upon his further request, an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown che data wichout any charge to him and, if he desires, shall be informed of the content <br /> and meaning of rhat data. After an individual has been shown[he private data and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or action pursuant to this section is pending or addidonal data on[he individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon reques[by the individual subject of the data. The responsible au[horiry <br /> may require the requesting person to pay the actual cosu of making, cemfying, 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 requesi,excluding Saturdays,Sundays and legal holidays,if immediate compliance is no[possible. If he cannot comply with the reques[ <br /> within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal ho(idays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accumcy or completeness of public or private <br /> data conceming himself. To exercise this right,an individual shall no[ify in writing[he responsibie authoriry dzscribing the nature of the disagreement. <br /> The responsib(e authority shall within 30 days either: (a)correc[the data found to be inaccurate or incomplete and atcempt to norify past recipients of <br /> inaccurate or incomplete data, including recipiencs named by the individual; or(b) notity the individual that he believes the data to be correcc. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinacion of the responsible authority may be appealed pursuant ro the provisions of the administrative 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 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 requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the pernut or license. <br /> 3. The information may be shared with other local, state or federal a�encies 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 /> j. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. <br /> E. Your full name is required to process this application or permit. <br /> Firs� r � !/�Q � <br /> � r� vliddle Last <br /> 7�z �l�� I��` <br /> Address <br /> [h w� �ws f �n /Ldr.� S�3/'� ��'j0—UL-. 7/ <br /> ��n, State Z�p Phone <br /> I understand m rights stated above. <br /> � <br /> Signatu <br />