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� � <br /> Sec.13.04 RIGHTSOFSUBJECTSOFDATA <br /> Subdivision 1. Type of data The rrghts of rndividuaf on whom the data is stored or to be stored shall be as set forth in[his section. <br /> Subd.2. Injormalion required!o be given individuaL An indivrdual asked to supply private or confidential data concerning himselj <br /> shall be informed of.� (a)the purpose and intended use of the requested data within the collecting state agency,political subdivisian,or slatewide <br /> system;(bJ whether he may refuse or is legally reguired to supply the requested data;(c)any known consequence arising from his supplying or <br /> refusrng to supplyprivate or confidential data;and(d)the identiry ojother persons or entitres authorized by state orfederal law to receive the data. <br /> This requiremenl shall not apply when an individua!is asked to supply investigative da1a,pursuant to sectron 13.82, subdivisron S, to a!mv <br /> enforcement o�cer. <br /> The commissioner o�revenue may place the notice required under this subdivisron in the individual incorne tax or property tax refund <br /> instructions instead oI 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 whether it is classrfied as public,private or confrdential. Upon his further request,an rndrvidual who is the <br /> subject of stored private or public data on individuals shall be shown the data wrthout any charge to him and, if he desires,shall be informed of <br /> the content and meaning ojthat data. After an rndivrdual has been shown the private data and informed of its meaning, the data need not be <br /> disclosed to him for six months lhereafter unless a dispute or action pursuant to lhis section rs pending or additional data on the individua!has <br /> been collected or created. The responsible authority shall provrde copies of the private or public data upon request by the individual subject of <br /> the data. The responsible authority may require the requesting person to pay the actual costs of making,cert�ing,and comprling the copies. <br /> The responsible authority shall comply immediately,ifpossible,with any request made pursuant to this subdivrsion,or within five days <br /> of 1he date ojthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possrble. IJhe cannot comply ivith the <br /> request within that time,he sha/l sa inform lhe individual,and may have an additional five days tivithin whrch to comply ivith the request,excludrng <br /> Saturdays,Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An rndividual may contest the accuracy or completeness ofpublic or private <br /> data concerning himself. To exercise this right, an individual sha[l notify in writing the responsible authorrry describrng the nature of the <br /> disagreement. The responsrble authoriry shall within 30 days either: (a)correct the datafound to be inaccurate or incomplete and attempt to notify <br /> past recrprents of inaccurate or incomplete data,including recipients named by the individual;or(b)not�the rndividua!that he belreves the data _ <br /> to be correct. Data in drspute shall be disclosed only rf the individual's statement of drsagreement rs included with the drsclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant to the provisrons of the administrative procedure act relating � <br /> to contested cases. <br /> DATA PRIVACYADVISORY <br /> In accordance with M.S.13.04,Subd.2,"Rights ofsubjects ofdata",we would like to rnform you that your reguest for a permit or license <br /> from the City of Orono or any of its departments may require you to furnish certain private or confrdential information. <br /> You are notified that. <br /> 1. The information you jurnish wil/be used to determine your qua/ification for the permit or license requested. <br /> 2. You may rejuse to supply data,but refusal 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 process the permit or <br /> license. <br /> 4. If your requested permit or lrcense requires Councrl actron lo approve,some information may become public. <br /> S. You have certain rights under M.S. 13.04(see jollowrng page)to review private data on yourself. <br /> 6. Your ful!name is required to process this applrcation or permit. <br /> PLE SE PRINT <br /> � ,�_ ` <br /> ,4(`� ������,�1 �� f �gq('� <br /> First Mrddle Last <br /> ���� � � <br /> Address <br /> 1 � I 1�-1if'��In 1 ��—�h—�N �5 ��`—F— <br /> Crry State Zip Phone <br /> understand my rig s as �ted above. <br /> � j� �� <br /> ignalure <br /> ]0 <br />