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Sec.13.04 RIGHTS OF S[JBJECTS OF D�TA <br /> Subd. 1. Type of data. The rights of individuai on whom the data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information reqirired to be given individual. An individual uked to supply private or confidendal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of[he requesud data within the collecting�tate agency,polidcal subdivision,or sratewide rystem; <br /> (b)whether he may refuse oY is legaliy requimd to supply the requested data;(c)any Faown consequence arising from his supplying or refusing to supply <br /> private or confidenaal data;and(d)the idenriry of ocher persons or enriaes auchorized by state or federal law to receive the data. This requ'uement shall <br /> not apply when an individual is asked to supply invesrigarive dam,pursuant to secaon 13.82,subdivision 5,to a law enforcemenc officer. <br /> The commissioner of revenue mav place the noace reouired under this subdivision in the individual income tax or oropem tax refund <br /> instructions inscead of on those forms. <br /> Subd. 3. Access to data by individual. Upon requesc 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 confidendal. Upon his further request,an individual who is the subject <br /> of stored private or pubiic data on individuals shall be shown�he data wichout any charge to him and,if he desires, shall be informed of the contenc <br /> and meaning of�hat data. Afrzr an individual has been shown the privace data and informed of its meaning,the dara need not be disclosed to hirn for <br /> six months thereafter unless a dispute or acnon pursuan�to this secrion is oending or addidonal data on the individual has been collected or crea[ed. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesring person to pay the actual costs of making,cervfying,and compiling the copies. <br /> The responsible authoriry shall comply immediately, 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►egal holidays,if immediate compiiance is not possibie. If he cannot comply wirh the reques[ <br /> within that time,he shall so inform the individual,and may have an addioonal five days within wtuch to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. M individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shall nodfy in wridng the responsible authoriry describing the nacure of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccunte or incompiete data, including recipients named by the individual;,or(b)noufy the individual that he believes the data to be correct. Data <br /> in dispuce shali be disclosed only if the individual's statemenc of disagreement is inciuded with the disclosed dara. <br /> The decerminarion of rhe responsible authoriry may be appealed pursuant to the provisions of the adminisaarive procedure act reladng to <br /> con[ested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Ri;hts 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 furnish certain private or <br /> confideatial information. <br /> You are notified that: <br /> 1. The information you furnish will be used to deternune your qualification for the pemut or license 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 wich other local, state or federal agencies to the extent 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 ri;hts under N1.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 /> , <br /> � � � ) <br /> � � { � .. ��)��;f J�l �C.��' ���c:y`-� <br /> First Middie Last <br /> '=; �`�'�� �-v�"�� �✓� � ' <br /> Add;ess } � , �� <br /> � <br /> �/�19(���/2i l� �l l�� '� �a �� 7�'�L� � I�' ��:' �' <br /> Ci� State Z�p Phone <br /> I understan �rz�( �i ts as_st � d above. <br /> -�i�l�-� <br /> Signature <br />