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t <br /> Sec.13.04 RIGH'TS OF SUBJECTS OF DaTA . <br /> Subd. 1. Type of data. The rights of individual on whom rhe data is s[ored or to be stored shali be as set forrh in this secdon. <br /> Subd.2. Information req�rired to be givea individual. Art individual azked ro supply private or confideadal data concerniag himself shall <br /> be informed of: (a)the purpose aad inrended use of the requesred data wirhin tt�e collecang Ytate agency,polidcai subdivision,or statewide sysum; <br /> (b)whether he may refuse oY is legatly required to supply the requesud data;(c)any known coatequence arising from his suppiying or refusing to supply <br /> priva�e or confidential data;and(d)the idenriry of o[her persons or enrides aurhorized by sta[e or federal iaw to receive the dara. This requirement s6a11 <br /> not apply when an individual is asked to supply invesrigadve dara,pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the noace rauired under rhis subdivision in the individual income rax or nropertv taz refund <br /> instructions inscead of on chose forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and wherher it is classified as public,priva�e or confidential. Upon his further requesc,an individual who is[he subjecc <br /> of stored private or public data on individuals shall be shown the dara wi[hout any charg�to him and;if he desires, shall be informed of the content <br /> and meaning of chat data. Aher an individual has been shown che private dara and informed of ics meaning,the data need not be disclosed to him for <br /> six mon[hs thereafter unless a dispute or acdon pursuan[to chis secrion is pending or additional data on the individual has been collected or created. <br /> The rosponsibie 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 actua!costs of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,wich any request made pursuant to this subdivision,or within five days of <br /> the date of ihe request,excluding Saturdays,Sundays and legal holidays,if immedia[e compliance is not possible. If he cannot comply with the request <br /> within that dme,he shali so inform the individual,and may have an additional 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 compiete. An individual may contest the accuracy or completeness of public or pri�•ate <br /> data concerning himself. To exercise chis right,an individual shall nodfy in wridng the responsible authoriry describing[he nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correc�the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccunte or incomplete data, including recipients named by[he individual;or(b)notify the individual that he believes the data to be corcect. Data <br /> in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. <br /> The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to <br /> contested cases. <br /> DATA PRIVACY �DVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Righu of subjecu 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 suppiy data, but refusal may require that the Ciry deny the permit or license. <br /> 3. The information may be shared with ocher local, state or federal agencies to the extent necessary to process <br /> 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 /> ��S ��,�� �,,,�^ <br /> First Middle Last <br /> �4�� Si���t'r �c � <br /> Aa�K�s5 <br /> l.�-�N-rz-..�-�- tM�-f .S`�`�� q�Z-`�?1'� 'f� <br /> City Start Zip Phone <br /> I understand y rights as stated above. <br /> Signamre � <br />