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Sec.13.04 RIGHTS OF SUBJECTS OF DATA ' <br /> Subd. 1. Type of data.`'£he rights of individual on whom the data is stored or to be stored shall be a�set forth in this section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himselfshall be <br /> informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legal ly required to supply 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 suthorized by state or federal law to receive the data.This requirement shal I <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement ofticer. <br /> Th �inmissioner of revenue mayplace the notice reauired under this subdivision in the individual income tax or propertv tax refund � <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individuai. Upon request to a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classitied as public,private or confidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data witltout any charge to him and,if he desires,shall be informed of the content and , <br /> meaning of that data. After an individual has been shown the private data and infonned of its meaning,the data need not be disclosed to him for six <br /> months thereatter 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 daw. 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 tive 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 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 /> Subd.4.Procedure when data is not accurate or complete. An individual may concest the accuracy or completeness of public or private data <br /> concerning himsel£ To exercise this right,an individual sltal l notify in writing the responsible authoriry describing the nature of the disagreement.The <br /> responsible authority shall within 30 days either: (a)correct 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)notit'y the individual that he betieves 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 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 <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 /> public. <br /> 5. You have certain rights under M.S. 13.04(available upon reyuest)to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> First Middle Last <br /> � (c.a-1�4-I Z�) C �'I(CK.SC�L <br /> Address <br /> 2��� Li��(�(,�t�Ztti� LA-n18� i"�f�Fl,�1�p►�� I'`'►N 5 535—`� 76�-�175- 6�d7 <br /> City __. _ State Zip Phonc <br /> ,I understand my rights as stated above. ' <br /> /, �J <br /> � j..- ���� <br /> ~ Signatu <br /> / <br /> Reset Form 3? <br />