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r <br /> ♦ <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of iiuiividual on whom the data is stored oc to be stored shall be as set forth in ttils section. <br /> Subd.2. Information req�rired to be glven individual. An individual asked to su�ly private or confidendal data conceming himself <br /> shall be informed of: (a)the purpose a�inteaded use of the roquested data within the collecting state agency,polidcal subdivision,or statewide <br /> system;(b)whether he may retuse or is legally required to supply the requesoed data;(c)any larown consequence arising from lris supplying or <br /> refusing to supply private or confidential data;and(d)the ideatiry of other persons or entiues aud�orized by state or federal law to receive the data. <br /> This requirement shall not apply when an.individual is asked w supply invesdgative data,pursuant to section 13.82, subdivision 5,to a law <br /> enforcement officer. • <br /> T1,P�nmmiccinrwr nf fCVEtIIP IILV DI3Cp the noticp rea�ired Lnder this subdivision in the individual income hax or orocettv tax refund <br /> instn►ctions insuad of on diose forms. <br /> Subd.3. Access to data by indivi�lual..Upon reqdest to a responsible authority;an iadividual shall be informed whether he is the <br /> subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who <br /> is the subject of stored private or public data on individuals sl�all be shown ihe data without any chazge to him and,if he desires,shall be informed <br /> of the content and meaning of that data. After an individual has been shown the private data and infocmed of its meaning,the daha need not be <br /> disclosed to him Sor six months thereafter unless a dispute or.acyon pu►�aut to this secdon is pending-oc additional data on the individual has been <br /> collected or createcl. The responsible authoriry shall provide copies of d►e private or public data uppn request by the individual subject of the data. <br /> � The responsible suthoriry may require the requesting person to pay the actuat costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply icnmediately,if possible,with any request made pursuant to this subdivision,or within five days <br /> of the date of the reqaest,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with <br /> the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request, <br /> excluding Saturdays,Sundays and legal holidays. <br /> � Stibd.4. Procet]ure when data is not accunate or lomplete. ,An indiyidual,may cOnt�.ct the acc,uracy or completeness of public or <br /> privaot data CBncerning�himself. To exercise this right,an individyal shpll notify in writing the respoesible authoriry describing the naNre of the <br /> disagreemetrc. The responsible aud�oriry shall within 30 days either. (�)cohect d�e da�fafnd oo be inaccurate or i�ompleoe and attempt to�tify <br /> past recipients of inaccutat�or iacomplete data,icxluding recipients namead by�tMe udiyidual;:pr(b)�dfy the individual that he believes the data <br /> to be correct. Data in dispuu shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The deumtination of dre rospoasible authority may be appealed pursusiit t0 the provisions of the administrative procedure act relating <br /> to 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 <br /> request for a permit or license from the Gity of Orono or any of its departments may require you to furnish certain <br /> private or confidential information. <br /> You are notified that: <br /> l. The information you furnish will be used to determine your qualification for the permit or license <br /> , _ , requested. <br /> ;;.;. , 2.. . ,You maX refuse to supply data, hut refusal may require that the City deny the permit or license. <br /> Y 3. � The information�may�be shated with�othei local, state or federal agencies tp the extent necessary to <br /> ;. . � ,. ' ~process the pei�miCor'ticense` ', � , . " '. , �. _ . ' <br /> ' : 4: � • Ifyour requ�sted permit of�'li�eese`�equires�eouncil acrion to:approVe; some�iuformation�may become <br /> . � , . •pubfic. � � <br /> 5. , You have certain rights under M.S. 13.04(available upon requestj to review private data on yourself. <br /> 6. � Your full name is required to process this application or permit. <br /> First Middle �s� <br /> Address <br /> C��y State Zip Phone <br /> I understand my rights as stated above. <br /> Signature <br /> 6 <br />