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Sec.13.01 RIGHTS OF SUB.TECTS OF DATA <br /> Subd. 1. Type oF data. The rights of individual on whom the data is stored or to be stored shall be as set fotth in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the colleccing state agency,political subdivision,or stacewide <br /> rystem;(b)whecher he may refuse or is legally required to suppty the requested data;(c)any Imown consequence arising from his supplying or <br /> refusing rfl supply private or coofidential dara;and(d)the idenriry of other persons or endties au�horized by srate or federa!law to receive the dara. <br /> This requirement shalf not apply when an individual is asked to supply investigadve data, pursuant to section 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> 'I�e commissioner of revenue mav olace the norice reauired under this subdivision in the individual income taz or orooerrv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the <br /> subject of stored data on individuals,and whether it is classified as public,private or co�denrial. Upon his further request,an individual who <br /> is the subject of stored private or public dara on individuals shall be shown the data without any charge to him and, if he desires,shall be informed <br /> of the content and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning, the data need not be <br /> disclosed co him for six months thereafter unless a dispute or acdon pursuant to this secrion is pending or addirional data on the individual has been <br /> collected or created. The responsible authoriry shali provide copies of the private or public dara upon request by the individual subject of the data. <br /> The responsible au[horiry may require the requesring person to pay the actual costs of making,certifying,and compiling the copies. <br /> 'Ihe responsible authoriry shall compty immediately,if possib(e,with any request made pursuant to this subdivision,or within five days <br /> of the dace of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with <br /> [he request wichin that cime, he shall so inform the individual, and may have an addiaonal five days within which to comply with the request, <br /> excluding Saturdays,Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or <br /> private dara conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing the nature of the <br /> disagreement. The responsibie authoriry shall within 30 days either: (a)correct the daa found tn be inaccurate or incomplete and attempt to nodfy <br /> past recipients of inaccurate or incomp(ete dara,including recipienu named by the individual;or(b)nodfy the individual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinacion of the responsible authority may be appealed pursuant to the provisions of the administraove procedure act relaan, <br /> to contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with Ni.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your <br /> request for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain <br /> private or 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 <br /> 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 <br /> process the permit or license. <br /> 4. If your requested pemut 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) [o review private data on yourself. <br /> 6. Your full name is required to process this application or pernut. <br /> I�; ��N(��,� +�N y ; .:�N�-(V <br /> Firs[ - Middle Last <br /> i <br /> �� <br /> '�-�`' L ��;'1��:= '�.i . <br /> Address <br /> ' :�TCV�i ' i. ��` r ,� � �t' � t `�' - `. :x <br /> � - � �_: �� ��� _.- - <br /> C��Y , State Zip Phone <br /> I unde,rsfa,�d�y rights as stated above. <br /> i ;' <br /> ; <br /> 1��, �_:_ <br /> Signature <br /> �_ <br /> 6 <br />