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� `. <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA , <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information reqtrired to be given indivIdual, qn individua!asked to supply private or contidential data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide <br /> rystem;(b)whether he may refuse or is legaUy required to supply the requesud dara;(c)any tmown consequence arising from his supplying or <br /> refusing co supply private or confidenaal data;and(d)the idendry of other persans or eadaes authorized by srau or federal law ro receive the data. <br /> This requirement shall not apply when an individual is asked to supply invesNgative data, pursuant to section 13.82, subdivision 5, to a law <br /> enforoement officer. <br /> The commissioner of revenue mav olace the notice rewired under this nibdivision in the individual income taz or nro�ertv tax refvnd <br /> instru�rions instead of on thoce fortns. <br /> Subd.3. Access to data by iadiridual. Upon request to a responsible authoriry,an individual shall be informed whether he is the <br /> subject of stored data on uidividuals,and whether it is class�ed as public,private or co�denaal. Upon his further request,an individual who <br /> is the subject of stored private or public data on individuals shall be shown the data without any charge 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 informed of its meaning,the data need not be <br /> disclosed to him for siu months thereafter unless a dispute or acaon pursuant to this section is pe�ing or addidonal data on the individual has been <br /> coilected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible auchoriry may require the requesdng person W pay the actual cosu of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,wich any request made pursuant ro this subdivision,or wi[hin 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 time,he shall so infocm the individual,and may have an addiaonal five days wirhin which to comply with the request, <br /> excluding Saturdays,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 data concerning himself. To ezercise this right,an individual shall nodfy in writing the responsible authoriry describiag the t�ature of the <br /> disagreement. The responsible audioriry shall within 30 days either: (a)correct the data foucyd to be inaccurate or i�xomplete and attempt w notify <br /> past recipients of inaccurate or incomple[e data,including recipienu named by the individual;or(b)nodfy the individual that he believes the dara <br /> m be coaect. Daca in dispute shall be disclosed only if the individual's sratement af disagreement is included with the disclosed data. <br /> The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relating <br /> to contesmd cases. <br /> DATA PRNACY ADVI ORY <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 �ity of Orono or any of iu departments may require you to furnish certain <br /> private or confidential information. <br /> You ue notiFed 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 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 acdon 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 pemut. <br /> First Middle <br /> Last <br /> Address <br /> C�ry' State Zip Phone <br /> I understand my rights as stated above. <br /> �.�, 21��- ' <br /> Signature � <br /> 6 . , <br />