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1 <br /> Sec.13.04 RIGHTS OF S[TB.TECTS OF DATa <br /> Subd. 1. Type of data. 'Ihe righcc of individual on whom the data is stored or to be scored shall be as set forth in chis secdon. <br /> Subd.2. Information reqtrired to be given individual. An individual asked to supply private or confidenaal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requesied data wi[hin the collecting�tate agency,polidcal subdivision,or statewide sysum; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any lrnown consequence arising from lus supplying or refusing W suppty <br /> privace or confidendal data;and(d)the idendry of ocher persons or enddes authorized by state or federal law to receive rhe data. This requirement s6a11 <br /> not apply when an individual is asked to suppiy invesdgadve dara,punuanc to secrion 13.82,subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the nodce rewired under this subdivision in the individual income tax or propertv tax refund <br /> instmcdons instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whecher it is classified as public,private or confidendal. Upon his further request,aa individual who is the subject <br /> of stored private or public data on individuals shall be shovm che dara without any charge to him and,�if he desires, shall be informed of the content <br /> and meaning of[hat data. After an individuai has been shown[he private data and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsibie authoriry shalt provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesring person to pay the accual coscs of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or withitt five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compty with the request <br /> within that time,he shall so inform the individual,and may have an additional 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 individual may contest the accuracy or completeness of pubiic or private <br /> data conceming himself. To exereise this right,an individual shali nodfy in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsible authority shall within 30 days eicher: (a)correcc the data found to be inaccurate or incompie[e and attempc to nodfy past recipienu of <br /> inaccurate or incomplece data, including rocipients named by the individual;or(b)nodfy the individual tha[he believes the data to be correcc. Data <br /> in dispuce shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administcadve procedure act relating to <br /> contested cases. <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 fumish certain private or <br /> confidential information. <br /> You ue notified that: <br /> 1. The information you fumish 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 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 permit or license requires Council action to approve, some information may become <br /> public. <br /> g, 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 /> First Middle Last <br /> Address <br /> Ciry State Zip Phone <br /> I understand my rights as stated ve. <br /> Signature <br />