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'ti <br /> � <br /> Sce.13.04 RIGH'TS OF SLfBJEC'TS OF DaTA <br /> Subd. 1. Type of data. 'Ihe righa of individual on whom the data is stoced or to be stored shall be as set fo�th in this uction. <br /> Subd.2. Information reqirired to be givw iadividual. .1n individual uked ro supply privaee or confideadal dara coacerning himself sha11 <br /> be informed of: (a)the purpose and iamaded use of the requesud data within the collecting�tate agency,polidcal subdivision,or sratewide rystem; <br /> (b)whechec he may refuse oY is legally required to supply the czquesud data:(c)any Imown coauquence arising from his supplying or refusing to supply <br /> private or conHdenaal data;and(d)the ideariry of o[her persons or enddes authocized by state or fedecal law w receive the data. 'Ibis requirement shall <br /> not aQply when an individual is asked to supply invesdgadve data,pursuanc to secdon 13.82,subdivision 5, to a Iaw enfocoement officec. <br /> The commissioner of revenue mav alace the nodce czwired under this subdivision in che individual income rax or prooem tax refund <br /> instructions instead of on those forms. � <br /> Subd.3. Access to data by individual. Upon request to a responsibte authoriry,an individual shall be informed whether he is the subjecc <br /> of stored data on individuals,and whe[her it is c(ass�ed as public,private or confidenrial. Upon his further reQuest,an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown the data wirhout any chacge ro him and;if he desires,shall be informed of the content <br /> and meaning of chat data. Afur an individual 6as been shown the private data and informed of its meaning,the data need not be disclosed to him for <br /> six mondu theteafter unless a d'upute or acdon panvant to[his secdon is pending or addiaonal data on the individual has been collected or created. <br /> The responsible authority shall pmvide copies of the private or public data upon request by the individual subject of�he data. The responsible authoriry <br /> may require the requesring person to pay the acaal cosu of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any requesc made pursuant to this subdivision,or within five days of <br /> the dau of rhe tequesc,eacluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannoc comply with the request <br /> within chat dme,he shall so inform ehe individual,and may have an addidoaal five days wirhin 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 individuat may contest the accuracy or completeness of public or private <br /> data conceming himself. To exercise chis right,an itidividual shall nodfy in wridng ehe respoasible authoricy describing the naare oF the disagreement. <br /> The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccucate or incomplece and atcempc m nodfy past recipienu of <br /> inaccurate or incomplete data, including recipients named by che individual;or(b)nodfy the individual that he believes the data to be correcc. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included wi[h the disctosed data. <br /> The determinadon of the responsible authoriry may be appealed pursuant to the provisions of rhe admuusaadve procedure act reladng co <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 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 /> � � i. 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 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 /> 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 /> Sa,U�I�e✓SQ <br /> F�� !D ll�?hd�-Ve Ne✓ �d�e �� <br /> �"�b�n�dti �e til l�/ �4�aa �3 3-��a . <br /> Ciey State Zrp Phone <br /> I understand my rights as stated above. <br /> Signamre <br />