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, . <br /> Sea13.04 RIGHTS OF S[JBJECTS OF D?.TA <br /> Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Informatioa reqirired to be given individual. An individual asked to supply private or confidenaal data concerning himself sha11 <br /> be informed of: (a)�he purpose and intended use of the requested data within the collecdng"state agency,political subdivision,or statewide system; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any]rnown consequence arising from his supplying or refusing to suppiy <br /> private or confidenaal data;and(d)the idenriry of other persoas or enriaes authorized by state or federal law to receive the data. This requirement shall <br /> not appty when an individual is asked to suppiy invesrizarive dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissionet of revenue mav place the nodce reauired under chis subdivision in the individual income tax or DroperN taz refund <br /> instructions instead of on those forms <br /> Subd.3. Access to data by indiridual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whe[her it is classified as public, private or co�denrial. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data wi[hout any charge to him and,-if he des'ues, shall be informed of the content <br /> � and meaning of[hat data. Aftzr an individual has been shown the private data and informed of its meaning,the data need not be disclosed ro him for <br /> six months thereafter unless a dispute or acdon pursuanc to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authority shall provide copies of the private or public data upon request by the individual subject of che data. The responsible authoriry <br /> may require the requesdng person ro pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible,wich any request made pursuant to this subdivision,or within five days of <br /> the date of the request,exciuding Saturdays,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 the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. , <br /> Subd.4. Procedure when data is not accurate or complete. An mdividual may contest the accuncy or completeness of public or private <br /> data conceming himself. To exercise this right,an individual shall notify in wricing the responsible authoriry describing�he nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempc to nodfy past recipienrs of <br /> inaccucate or incomplete data, inciuding recipients named by che individual; or(b)noufy the indi�idual that he believes the data to be correct. Data <br /> in dispuce shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The decerminacion of the rzsponsible authoary may be appealed punuant to the provisions of the administrative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> T In accordance with M.S. 13.04, Subd. 2, "Ri;hts of subjects of data", we woul�like to in�orm you that your request <br /> for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license requested. <br /> �2. Ybu may refuse to supply data, but refusal tnay 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 pemut 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 /> 4 /� �1�� <br /> �o�.Ji[� �. G�pT(ti� <br /> First Middle Last <br /> 0�.1�13o rn: �r�st.�oc,�-q.. "�\v��.. -- <br /> Address <br /> E.xe� \S.o� �Y►IU 553�1 9Sd1-�ol-U3�b0 <br /> Ci Srate Zip Phone <br /> I un rstand my ri ts as stated abov <br /> � <br /> Signa re <br />