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<br /> Sec.13.04 RIGHTS OF SLIBJECTS OF DATA
<br /> Subd. 1. Type of data. The rights of individual on whom the dara is stored or to be stored shall be as set forth in this section.
<br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data concerning himself shall
<br /> be informed of: (a)the purpose and intended use of the requested dara wirhin the collecting'state agency,political subdivision,or statewide system;
<br /> (b)whether he may refuse or is legally 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 idenary of other persons or entiries authorized by state or federel law ro receive the data. This requirement shall
<br /> ❑ot apply when an individual is asked to supply investigadve data, pursuant to secaon 13.82, subdivision 5, to a law enforcement off'icer.
<br /> The commissioner of revenue may place the notice required under this subdivision in the individual income taz or propertv tax refund
<br /> inst7uctions instead of on those 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 whecher it is dassified as public, private or confidential. Upon his further request,an individual who is the subject
<br /> of stored private or public data on individuals shall be shown the data without any charge to hun and, if he desires, shall be informed of the content
<br /> and mesning of that data. Afrer an individual has been shown the private data and informed of its meaning,che data need not be disdosed to him for
<br /> six months thereafter unless a dispute or acdon pursuant to this section is pending or addidonal data on tne individuai aas oeen coliected o:c:eated.
<br /> The responsib!e authority 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 acrual costs of making, cemfying, and compiling the copies.
<br /> The responsible authoriry shall compty immediately, if possible, with any request made pursuant co this subdivision, or within five 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 dme,he shall so inform the individual,and may have an addirional 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 complete. An individuai may contest the accuracy or compieteness of public or private
<br /> data concerning hunself. To exercise this right,an individual shali notify in writing the responsible authoriry describing the nature of the disagreement.
<br /> The responsible authoriry shail within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past rPcipients of
<br /> inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be cor.'ect. Data
<br /> in dispute shall be disclosed only if the individual's statement of disaereement is included with the disclosed data.
<br /> The determination of the responsible authoriry 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 certa.in private or
<br /> confidential information.
<br /> You are notified that:
<br /> 1. The information you furnish will be used to detemune your qualification for the pemut or license requested.
<br /> 2. Ye�.: ^:a;� refi�se te st�pply data, but refusal maY require that the City deny the permit or license.
<br /> 3. The information may be shazed with other local, state or federal agencies to the extent necessary to process
<br /> the pemut 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 /> i�la.d�eQ�. I)�=c-I �� �w�-
<br /> First iddle Last
<br /> Cl$�� �`�'� U �, �'
<br /> Address ��� �� l„� l�� �.�'lj,,, ����—.
<br /> 1 a,( v� t+�(N `�I ��75`1 ��
<br /> C�ry State Zip Phone
<br /> I understand my rights as stated above. .
<br /> iJa�,�,�,,,�, ;,,,,�_ '�a ✓�1 '��,r�,�. �7 . ;���.�,P,�:
<br /> Signature
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