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Sec.13.04 RICHTS OFSUBIECTS OFDATA <br /> Subdivision/. Type ojdata The rights of individual ox whom the data is stored or Jo be slored sha/l be as se!forth in thfs sectid�i. <br /> Subd.2. Injormation tequfred to be given ixdivtduaL An indivldual asked to supply private or conJdentia!data concerning hrmse f <br /> shall be informed oj.• (a)the purpose and intended use of the requesled data within the collecting state agenty,political subdivrsion,or statewide <br /> system;(bJ whether he may refuse or is legally requlred to supply the requested data;(c)any knotivn consequence arising from hrs supplying or <br /> refusing to supplyprivale or confrdential data;and(d)the identity of otherpersons or enlilies aulhorized bystate orfederallaw to receive[he data. <br /> This�equiremenl shall not apply when an fndividual is asked to supply imestigative data,pursuant to section 13.87, subdivision S, to a Imv <br /> exjorcement ogcer. <br /> The commissioner oJrevenue mav nlace the xotice reouired under this subdivision rn the indrvrdual income tax or Dronertv tax refund <br /> . trutnrctiorrs rrrstead olon those forms. <br /> Subd.3.Access to data by indfvlduaL Upon request to a resporuible authoriry,an individualshall be informed whether he is the subject <br /> o,f slored data on individuals,and whether it is classifred as public,private or confrdential. Upon his further request,an individual who fs the <br /> subject oJseored private or public data on individuals shall be shown the data without arry charge to him and,if he destres,shal!be informed oj ' <br /> the con�enl and meanrng of that data. After an rndividual has been sAown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six monlhs�hereafter unless a dispute or ac�ion pursuant to lhis section is pending or additiona!data on the individua!has <br /> been co!!ec[ed or created. The responsible authority shall provtde copies oJthe private or public data upon reques!by the individual subject of <br /> the data. Tfre resporrsible authority may require the requesting person to pay�he actua!costs of making,cert�in&and compiling the copies. <br /> The responsible aurhority shall comply immediately,ifpossible,with arry request made pursuant to this subdivision,or wi[hinfrve days <br /> ojthe date of the request,excluding Saturdays,Sundays and legal holidays,rf immedrate compliance is not possible. I,f he cannot comply with the <br /> �equest wtthin thae time,he shal!so inform the individual,and may have an additional frve days within which to comply with the request,excludixg <br /> Saturdays,Suxdays and legal holidays. <br /> Subd 4. Procedure when data Is not accurate or complete An rndividual may contest the accuraty or completeness oJpublic orprivate <br /> data concesning himself. To exercise this righl, an individual sha!!not�in writing the responsible authori�y describJng the nature oJthe <br /> dfsagreemen�. The responsible authority sha!!wrthin 30 days either: (a)correc�the data found 10 be inaccwate or incomp/ete and attempt to not� <br /> past recipients ojrnaccurate or incomplete data,including recipients named by the indivtdual,•or(6)not�the indivtdual that he believes the data <br /> to be correct. Da[a in dispute sha!!be disclosed only!f the lndivrdua!'s slatement of disagreement is included with the disclosed data. <br /> 77re determinatian oJthe responsible authority may be appealed pursuant to the provisiorts oJthe administrative procedure act relating <br /> to contested cases. <br /> DATA PRIYACYADYISORY <br /> In accordance with M.S.13.04,Subd.2,"Rights oJsubjects oJdata';we would like to inform you that your requestfor a permit or licerue <br /> from the City oJOrono or a�ry of its departments may requi�e you to furnish certain private or confiden�ial lnjorma�ion. <br /> You are notifred that: <br /> 1. The injormation you jurnish wi![be used to determine your qualrfication for the permit or license requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the permlt or license. <br /> 3. The injormation may be shared with olher local,state or jederal agencies!o the extent necessary to process the permit or <br /> lice►rse. <br /> 4. If your requested permit o�license requires Counci!action to approve,some injormation may become public. <br /> S. You have certain rights under M.S. 13.04(see following page)to review private da�a on yourself. <br /> 6. Your full rrame is requrred to process thts application or permrl. <br /> PLEASE PRINT <br /> First Middle Last <br /> Address <br /> City State Zip Phone <br /> I understa ht s stated above. <br /> Signature <br /> 10 <br />