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� � � <br /> Sec.13.04 RIGH'1'S OF SITBJECTS OF DATA ' <br /> Subd. 1. Type o[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 req�rired to be given individaal. An individual asked to supply private or confidential data conceming himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecting�tate agency,political subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confiden6al data;and(d)the idenaty of other persons or entities authorized by state or federal law to receive ihe data. This requirement shall <br /> not apply when an individual is asked to supply invesdgaave data,pursuant to secdon 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav place the nodce required under this subdivision in the individual income tax or propertv taz refund <br /> instcuctions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be infoctned whether he is the subject <br /> of stored data on individuals,and whether it is classified as public,private or confidendal. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of die content <br /> and 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 <br /> six months thereafter unless a dispute or acdon pursuant to this secaon is pending or addidonal data on the 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 authoriry <br /> may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that tune,he shall so inform the individual,and may have an additional fivc days within which to comply with the request,ezcluding 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 notify in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccuiate or incomplete data, including recipients named by the individual;or(b)norify the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The detemunation of the responsible authoriry may be appealed pursuant to 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 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 eztent necessary to process <br /> the pernut 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 pernut. <br /> -,� � �. � ..� <br /> � � <br /> First � �dle Last <br /> �`9 —��_�/♦ er /T /�/ �� <br /> A dresfl s� <br /> v� -� � E �. �s� 7 � G. 7U �-O � �� <br /> C��y State Z�p Phone <br /> I understand my rights as stated above. <br /> Signatu <br />