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Sea13.04 RIGHTS OF SUBJECTS OF DATA ` <br /> Subd.1. Type of data. T6e rights of Indlvidual on whom the data is stored or to be stored shall be as set forth ln thls section. <br /> Subd.2. Information required to be given individual. An indlvidusl asked to supply private or contidential data concerning himseltshall be <br /> Informed o[: (a)the purpose and intended use of t6e requested data withln the rnllecting state agency,political subdivision,or statewide system;(b) <br /> whether 6e may retuse or is legally required to supply the requested data;(c)any known rnnsequeoce arising from his supplying or retusing to supply <br /> private or contidential data;snd(d)t6e identity of ot6er persons or endties authorized by state or federal law to receive the data. This requirement shall <br /> not apply w6en an individual is ssked to supply investigative data,pursusnt to section 13.82,subdivislon 5,to a law enforcement officer. <br /> The commissioner ot revenue mav olace the notice reauired under this subdivision in the individual income tax or�rooertv tax refund <br /> Instructions instead ot on those forms. <br /> Subd.3. Access to data by individual. Upon request w a responsible authority,an individual shall be informed w6ether he is the subject of ' <br /> stored data on indlviduals,and whether it is classifled ss public,private or confidential. Upon hIs further request,an indlvidual who is the subject of <br /> stored private or public data on indlviduals shall be shown the data without any charge to 61m and,Ii he desires,shall be informed of the cootent and <br /> meaaing of that data. After an individual has been shown the private data and(nformed of its meaning,the data oeed not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this sectioo is pending or addltlonal data on the Individual has been collected or created. The <br /> responslble authority shall provide copies of the private or public data upon request by the individual subJect of the data. The responslble authority may <br /> require the requesting person to pay the actual rnsts ot making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,If possibie,with any request made pursuant to this subdivision,or w(thln tive days of the <br /> date ot the request,excluding Saturdays,Sundays and legal holidays,lf immediate compliance is not possible.If he cannot comply with the request within <br /> that time,he shall so inform the lndividual,aad may have an additional five days within which to comply with the request,excluding Saturdays,Sundays <br /> and legal holidays. <br /> Subd.4. Procedure whea data is not accurate or complete. An indivldual may contest the accuracy or completeness otpublic or prlvate data <br /> concerning himselL To eaercise this right,an individual s6a11 notify in writing the responsible authority describing the nature of the disagreement. T6e <br /> responsible suthority shall within 30 days elther: (a)rnrrect the data found to be inaccurate or inrnmplete and attempt to notify past reciplents o[ <br /> inaccurate or tncomplete data,including recipients named by the Individual;or(b)notify the individual that he believes the data to be correct Data in <br /> dispute s6a11 be disclosed only if the indivldual's statement of disagreement is lncluded with the disclosed data. <br /> The determinatlon of the responstble authorlty may be appealed pursuant to the provislons 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 /> confdential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or Gcense 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 eatent 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 /> First Mlddle Last <br /> Address <br /> City State Zip Phone <br /> I understand my rights as stated above. � <br /> _� /LY1�! _ C���' ( �l/./i�1��C:-iC-���s--�— <br /> Signature <br />