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Y � <br /> Sec.13.04 RIGHTS OF SUBJECTS OF D�1T� <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or[o be stored shall be as set forth in[his secdon. <br /> Subd.2. Information reqirired to be�ven individual. An individual asked to supply priva[e or confidenaal data concerning himself shall <br /> be informed of: (a) the purpose and inrended use of the requesced dara wichin[he collecang'state agency, poliacal subdivision,or stacewide system; <br /> (b)whether he may refuse or is legally required co supply the requested dara;(c)any Imown consequence arising from his supplying or refusing to supply <br /> priva[e or confidendal data;and(d)the idendry of o�her pzrsons or enrides authorized by state or federal law co receive the data. This requirement shall <br /> noc apply when an individual is asked co supply invesogadve da�a, pursuanc to secaon 13.52, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the nodce required under �his subdivision in the individual income tax or prooertv taz refund <br /> instrucrions inscead of on chose forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsibfe authoriry,an individual shall be informed wherher he is the subject <br /> of stored data on individuals,and whecher it is classified as public, private or confidendal. Upon his futther requesc,an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown che data wi�hout any charge to him and, if he desues, shall be informed of[he contenc <br /> and meaning of thac data. After an individual has been shown che private dara and informed of i�s meaning,the data need noc be disclosed to him for <br /> six months thereafter unless a dispuce or acrion punuant to [his secaon is pending or additional data on che individual has been collected or creaced. <br /> The responsibie authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require che requesnng person to pay the accual coscs of making, cerrifying, and compiling the copies. <br /> The responsibfe authority shall comply immediately, if possible, wich any requesc made pursuant to this subdivision, or within five days of <br /> the dace of the reques�,exciuding Sacurdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform[be individual,and may have an addiaooal five days wi[hin which to comply with the request,excluding Sa[urdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contesc[he accuracy or completeness of public or private <br /> data concerning himself. To exercise chis right,an individual shall norify in writing[he responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shal!wirhin 30 days eicher: (a)correcc[he data found to be inaccurate or incomplete and attempt to noafy past recipients of <br /> inaccurace or incomplete data, including recipiencs named by the individual; or(b)nodfy the individual tha[he believes the data to be correct. Data <br /> in dispuce shali be disclosed only if che individual's statement of disagreement is included wi[h the disclosed data. <br /> The decerminacion of the responsible authoriry may be appealed pursuant to the provisions of the adminisaative procedure act refating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Rights of subjeccs of data", we would like to inform you that your request <br /> for a permit or license from the City of Orono or any of its departments may require you to fumish cenain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to detecmine your qualification for the permit or license requested. <br /> 2. You may refuse 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 <br /> the permit or license. <br /> 4. If your requested perm.it or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certai.n rights under M.S. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is required to process chis application or permi[. <br /> � c� c / �" �� � ' � <br /> First Middle ast <br /> -�`�,� ���� � �.�� <br /> Address <br /> �. , �� ��� ��3�� �1\ -� � <br /> Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> � <br /> \ <br /> Signa�ure <br />