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Sec.13.OJ RIGHTS OF SUBJECTS OF DATA ,+ <br /> Subd. 1. Type of data. The rights of individual on whom tlie data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individuai. An individuai asked to supply private or contidential data conceming himself shall be <br /> informed of. (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to suppiy the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity of other persons or entities nuthorized by state or federal law to receive Uie data.This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforceme�t officer. <br /> The commissioner of revenue may olace the notice required under this subdivision in the individual income tax or groper tax refund <br /> instructions instead of on those forms. <br /> 5ubd.3. Access to data by individuol. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classitied as publ ic,private or confidentiaL Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be sho�vn the dlta without any charge to him and,if he desires,shall be infortned of the content and <br /> meaning of that data. After an individual has been shown the privlte data and informed of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority 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 cosu of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request mnde pursuant to this subdivision,or within tive days of <br /> the date of the request,e�cluding Saturdays,Sundays and legal holidays,if immediate compl iance is not possible. [f he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, <br /> Swidays and legal holidays. <br /> 3 ubd.4.Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data <br /> conceming himself. To exercise this right,an individuai shall notify in writing the responsible authoriry describing the nature of the disagreeme�t.The <br /> responsible authority shall within 30 days either. (a)corcect the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual thnt he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority 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 inforni you that your request <br /> for a pem�it 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 /> i. 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 permit or license requires Council action to approve, some information may become <br /> ptiblic. <br /> 5. You have certain rights under IVI.S. 13.04(available upon request)to review private data on yourself. <br /> 6. Your full name is required to process this ap�lication or permit. <br /> �oP � �, Yo�,�► <br /> First �4iddle LHst <br /> 'Z a�� �` � . , <br /> A�ar�55 <br /> �-� � �`�"I o2 <br /> Cil�� Siate 7.ip Phone <br /> I understa d my rights as stat above. <br /> Signaturc <br /> Reset Form 3� <br />