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Sec.13.04 RIGHTS OF SUB.TECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom[he data is stored or to be 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 confidential dara concerning himself <br /> shalt be informed of: (a)the purpose and inxnded use of the requested dara within the collecang state agency,poliacal subdivision,oc statewide <br /> system;(b)whether he may reCuse or is legally requirod to supply the requesud data;(c)any known conseque�e arising from his supplying or <br /> rofiuing ro supply private or confidential dara;and(d)the idendry of other persons or endties authorized by state or federal taw ro receive the data. <br /> This requirement shall not apply when an individual is asked to supply investigadve data, pursuant to secdon 13.82, subdivision 5, to a taw <br /> enforcement o�cer. <br /> The commissioner of rovenue mav olace the notice reauired under this subdivision in che individual income tax or orocem+tax refi�nd <br /> instrucdons instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the <br /> subject of storod 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 individuais shall be shown the data widtout any charge to him and, if he desires,shall be informed <br /> of the content and meaning of that data. Aftec an individual has been shown the private data and informed of its meaning,the data need not be <br /> disctosed to him for six months thereaher unless a dispute or action pursuant to this section is pe�ing or addidonal dara on the individual has been <br /> collected or created. The responsible authority shall provide copies of[he private or public data upon request by the individual subject of the data. <br /> The responsible authoriry may require the roquesdng person to pay the acmal costs of making,certifying,and compiling the copies. <br /> The rospo�ssibte authoriry shail comply immediately,if possible,with any request made pursuant to rhis subdivision,or wirhin five days <br /> of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with <br /> the request within that dme, he shall so inform the individual, and may have an additional five days within which ro compiy with the request, <br /> excluding Saardays,Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or <br /> private dara co�uerning himself. To exercise this right,an i�ividual shail notify in writing the responsible authority describing the nature of the <br /> disagreement. The cesponsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or i�omplete ac�attempt to noafy <br /> past recipients of inaccurate or iiuomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinadon of rhe responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act rolating <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 Ciry of Orono or any of its departments may require you to fumish certain <br /> private or 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 <br /> requested. <br /> 2. You may refuse to supply data, but refusal may require that the Ciry 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 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 /> P� vJ �acolnan <br /> Fi/r�t Middle Last <br /> �[0 �.al� �i1.tK� �NI��.S <br /> Address <br /> 3� <br /> ' State Zip Phone <br /> � , MN '`�331 4'1.�=1121 <br /> I understand��i ri s stated above. <br /> 5��v14'S <br /> Sig tur <br /> 6 <br />