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� <br /> •� � <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The righrs of individual on whom rhe dara is stored or to be stored shall be as set forth in rhis secaon. <br /> Subd.2. Information required to be given iadividual. An individuai asked to supply private or confidential data conceming himself shall <br /> be informed of: (a)[he purpose and intended use of the requested data wi[hin the collecting§tate agency,polidcal subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requesced data;(c)any lmown consequence arising from his supplying or refusing to supply <br /> private or confidendal daca;and(d)the idenuty of o[her persons or enaaes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesdgative dard,pursuant[o secrion 13.82,subdivision 5, [o a law enforcement officer. <br /> The commissioner of revenue mav place the noece required under this subdivision in the individual income tax or vrooertv tax refund <br /> insavcrions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whe[her it is classified as public, private or co�dential. Upon his furcher request,an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown the data wiehout any charge to him and,'if he desires, shall be informed of the contenc <br /> and meaning of that data. After an individual has been shown the private data and informed of i[s meaning,the data need not be disclosed to tum for <br /> six months thereaher uniess a dispute or acdon pursuant to this secdon is pending or addidonal dara on the individual has been coilected or created. <br /> The responsible authoriry shall provide copies of rhe private or public data upon request by the individuai subject of rhe data. The responsible authoriry <br /> may require the requesting person to pay che actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immedia�ely,if possible,with any request made pursuant to 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 requesc <br /> within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding SaNrdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure�vhen data is not accurate oc complete. An individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shall nodfy in writing the responsible authority describing the nature of the disagreement. <br /> The responsible authoriry shail within 30 days either: (a)correct rhe data found to be inaccurate or incomplete and attempt to noafy past recipients of <br /> inaccurate or ineomplete data, including recipients named by che individual;or(b)noafy the individual[hat he believes the dara to be correct. Data <br /> in dispute shall be disciosed 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 Ciry of Orono or any of its departments may require you to fumish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you fumish will be used to determine your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the pemut or license. <br /> 3. The information may be shazed wich other local, state or federal agencies to the eztent 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 /> i1�l����} v►�L �-�� s/��!/C L L <br /> F��� Middle Last <br /> S,4 /�� � - <br /> Address <br /> Ciry State Zip Phone <br /> i <br /> I understand my rights as d abo . <br /> � <br /> Signature <br />