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� . ' � , " <br /> Sec.13.04 RIGHTSOFSUBJECTSOFDATA <br /> Subdivision 1. Type of data The rights of individual on►vhom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. lnjormation required to be given indivldunL An individual asked to supply private or confidential data concerning himselj <br /> shall be informed of (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or slatewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)arry known consequence arising from his supplying or <br /> refusixg to supplyprivate or confidential dala;and(d)the idenlity of otherpersons orentities authorized by state orfederal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply imestigative data,pursuant to section 13.82, subdivision S, to a law <br /> enjorcement o�cer. <br /> The commissioner ofrevenue mav place the notice required under this subdivision in the individual income tax or nrovertv tax refund <br /> instructions instead ofon those fo�ms. <br /> Subd.3.Access to data by lndividuaL Upon reques!to a responsible authority,an individual sha/l be informed whether he is the subject <br /> of stored data on individuals, and whether it is classrfred as publrc,private or confidential. Upon his further request,an individual who is the <br /> subjecl of stored private or public data on individuals shall be shown the data without mry charge to him and,if he desires,shall be rnformed oj <br /> the content and meanrng of that data. After an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six months lhereafter unless a dispute or action pursuant to this section is pending or additronal data on the individua!has <br /> been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individua!subject of <br /> the data. The responsible authority may require the requestrng person to pay the actua[costs of making,cert�rng,and corrrpi[ing the copies. <br /> The responsible authority shal!comply immediately,ifpossible,with arry request made pursuant to this subdivision,or within frve days <br /> of the date of the request,excluding Saturdays,Sundays and legal holidays,if immedrate complrance is not possible. If he cannot comply with the <br /> request within that 1ime,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding <br /> Saturdays,Sundays and legal holydays. <br /> Subd.4. Pracedure when data is not accu�ate or complete An indrvidual may contest the accuracy or completeness ofpublic or private <br /> data concerxing hrmself. To exercise this right, an indivrdua!shalJ not�rn writing the responsible authority describing the nature of the <br /> disagreement. The resporrsible authorityshall within 30 days either: (aJ correct the datafound to be inaccurate or incomplete and attempt to not� <br /> past recipients of inaccurate or incomplete data,including recipients named by the indrvidual;or(6J not�the individual that he believes the data <br /> to be correct. Data in dispute shall be drsclosed only if the individua!'s statement of disagreement is included with the disclosed data. <br /> The determination oJthe responsible authority may be appealed pursuaxt to the provisio»s of the administrative procedure act relating <br /> !o contested cases. <br /> DATA PRIVACYADVISORY <br /> In accordance with M.S./3.04,Subd.2,'Rrghts ofsubjec�s oJdata';we would lrke to informyou thatyourrequestforapermit or license <br /> from the City of Orono or any of its deparJments may require you to furnish certain private or confrdential informa[ion. <br /> You are notifred that: <br /> 1. The rnformation you furnish ivrll be used to determrne your qua/ification for the permit or licerrse requested. <br /> 2. You may re,fuse to supply data,but refusal may require that the City derry the permit or license. <br /> 3. The information may be shared with other local,state or fede�a/agencies to the extent necessary to process the permit or <br /> lrcense. <br /> 4. If your requested permit or licerrse requires Council action to approve,some injormation may become public. <br /> S. You have certain rights under M.S.13.04(see jollowing page)to review prrvate data on yourself. <br /> 6. Yous fu11 name is required to process lhis application or permit. <br /> PLEASE PRlNT <br /> First Middle Last <br /> Address <br /> City State Zip Phone <br /> I understand my rrghts as stated above. <br /> Signature <br /> 10 <br />