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� � <br /> . <br /> Sec.13.04 RIGATS OF SCTBJECTS OF DATA <br /> Subd. 1. Type o[data. 'Ihe righa of iadividual on whom rhe data is scored or to be smred shall be as set fonh in this section. <br /> Subd.2. Information req�rired to be pvw individual. An individual as�ed W supply private or coafidential dara conceming himself shall <br /> be informed of: (a)the purpose and inteaded use of the requesud data within the collecdng State agency,polidcal subdivision,or statewide rystem; <br /> (b)wheeher he may cefuse oti is legally nequired to supply�he:equesud data;(c�any kaown consequence arising from 6is supplying or refusing w supply <br /> priva[e or confidendai data;and(d)the idenary of o[her persons or enddes authorized by sate or federal law m meive rhe data. This requiremenc shall <br /> not apply when an individual is asked to Supp(y investigaave dara,punvant W secdon 13.82,subdivision 5,to a law enfoceement offiCec. <br /> The commissioner of revecrue mav olace the noace teauiied under this subdivision in the individual income tax or orooem raz refund <br /> instcucdons insuad of on those forms. <br /> Subd.3. Accas to data by individual. Upon request to a responsible authoriry,an individuai shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as pubtic,private or confidenoal. Upon his further request,an individual who is the subject <br /> 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 of the content <br /> aud meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be discloud oo hicn for <br /> siz months thereafter unlesa a dispute or acdon pursuanc to[his secrion is pending or addi6onal data on the individual has been coUected or created. <br /> The responsible authoriry shail provide copies of the private or public data upon nquest by the imdividual subject of the data. The responsible authority <br /> way m�uire the requesting person to pay the actual costs of making,catifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any nquest made pursuant to this subdivision,or within five days of <br /> the date of the nquest,exeiuding Saturdays,Sundays and legal holidays,if immediace compliance is noc possible. If he cannot comply with the request <br /> within that dme,he shall so inform the iadividual,and may have an addidoaal five days withia which to wmply with the nquest,excluding Sahudays, <br /> Sundays and legal ho(idays. <br /> Subd.4. Procedure whea data is not accurate or complete. An individuat may contest the accuracy or completeness of public or pmate <br /> data conceming himself. To exercise this right,an individual shall nodfy in wricing the tesponsible authority describiag the nature of die disagteement <br /> The responsible authority shall widiin 30 days either: (a)correct the data found ro be inaccurace or incomplete and aaempt to noafy past recipientc of <br /> inaccutate or incomplete data,inc(uding t+ecipients nazned by the individual;or(b)nodfy the individual that he believes the data w be correcc Data <br /> in dispute shall be disclosed oaly if the u►dividual's statement of disagreement is inciuded with the discloud dara. <br /> The determinaaon of the responsible authoriry may be appealed punvant to the provisions of the administcaave procedure act relating to <br /> contesoed aases. <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 request <br /> for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You aze notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license 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 process <br /> the permit or license. <br /> 4. If your requested permit or liconse requires Council action to approve, some informatioa 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 fu11 name is required to process this application or permit. <br /> �e� `� �"x.G..���Z <br /> First / I Middle r Last <br /> �(P � ('�l � �O �a— I� 4� <br /> Add r _ �Gl k� /�� 7� i7 �i ���" D��� <br /> 1�C� `n <br /> Ciry Staoe Zip Phone <br /> I understand my rights as stated above. <br /> �� <br /> Signamro - <br />