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5cc.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. I. Type of data. The rights of individual on whom the data is stored or to Ue 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 contidential dataconcerning himselfshail 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 ro supply the requested data;(c)any known consequence arising from his Supplyi��g of refusing to Supply <br /> private or confidential data;and(d)the identity ofother persons or entities authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.32,subdivision 5,to a law enforcement ofticer. <br /> The commissioner of revenue mav olace the notice required under diis subdivision in the individual income tax or orooertv ta�refund <br /> instructions instead of on those fonns. <br /> Subd.3. Access to data by individual. Upon requestto a responsible authorih�,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or contidential. Upon his fuRher request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without 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 informed of its meaning,the data need not be disclosed to him for si� <br /> months thereafler unless a dispute or action pursuant to this section is pending or additional data on the individuai 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 data. The responsible authoriry <br /> may require the requesting person to pay the actual costs of making,certitying,and compilin�the copies. <br /> The responsible authority shal I comply immediately,if possible,with any request rnade pursuant to this subdivision,or within tive days of <br /> the date of the request,e�cluding Saturdays,Sundays and fegal 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 Sacurdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is no[accurate or complefe. An individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To e�ercise this right,an individual shall notih�in writing the responsible authority describing the nature of die disagreement. The <br /> responsible authority shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt m notify past recipients of <br /> inaccurate or incomple[e data,including recipients named by the individual;or(b)notity the individual that he believes the d�ta co be correct. Data in <br /> disput�shal!be disci�sed only if the individual's statement of disagreement is induded with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions ofthe administra[ive procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADViSORX <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to infonn 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 refival 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(icense requires Council action to approve, some infom�ation may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yo�u•self, <br /> 6. Your full name is required to process this application or permit. <br /> First Nliddle Last <br /> Address <br /> Cih� State Zip Phone <br /> I vndc,s.and^:y rights as starec�,�a�ov <br /> _--� � /f <br /> .--� _ <br /> �./ <br /> Signaturc <br /> Reset Form �' <br />