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• , Y <br /> Sec13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.l. 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. Intormation required to be given i�dividual. An individual asked to supply private or confidential data concerning himself shall be <br /> intormed of: (a)the purpose and intended use ot the requested data within the rnllecting state agency,political subdivision,or statewide system;(b) <br /> whether he may retuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or contidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the dats.This requireme�t shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav�lace the notice reauired under this subdivision in the individual inrnme tax or orooertv tax refund <br /> tnstructions instead of on those torms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classit7ed ss pubiic,private or con£dentiel. Upon his turther request,an individual who is the subject of <br /> stored private or publlc data on individuals shall be shown the data without any charge to him and,i[he desires,shall be informed of the rnntent and <br /> meaning of that data. Aiter an individual 6as been shown the prlvate data and informed of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or actlon pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies ot the private or public data upon request by the individual subject of the data.The responsible authority may <br /> require the requcsting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,wlth any request made pursuant to this subdivision,or within tive days of the <br /> date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot compiy with the request within <br /> that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,Sundays <br /> and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An Individual may rnntest the accuracy or completeness of public or private data <br /> concerning himself. To exerclse this right,an tndividual shall notify in writing the responsible authority descrIbing the nature otthe disagreement. The <br /> responsible authority shall within 30 days either: (a)�rreM the data tound to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individusi;or(b)notify the tndividual that he believes the data to be correcG Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responslble authority may be appealed pursuant to the provisions of the administrative procedure act relating to <br /> rnntested cases. <br /> DATA PRIVACY ADVISORY <br /> . <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 are noti£ed 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 suppiy data,but refusal may require that the City deny t6e 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 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 /> V2- ��e� � � e 0^� <br /> First Mid e Last <br /> c <br /> 1.fC� ��� ,�x��ef� ��2 �IUc� <br /> Address <br /> ���s rQ�, MrNi�/ -���!' �'S 2.---�fly-�d 7 7 <br /> City State Zip Phone <br /> I under and my rights as stated above. <br /> Signature <br />