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Sec.13.04 RIGHTS OF SUI3JECTS OF DATA , <br /> Subd. 1. Type of data. 'I'he rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Infbrmation required to be given individual.An individual asked to supply private or wnfidential datawncerning himselfshall be <br /> informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legal ly required to supply the requested data;(c)any known consequence arising f?om his supplying or refusing to supply <br /> private or contidential data;and(d)the identity of odier persons or entities authorized by state or federal law to receive die data.This requirement 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 may place the notice required under this subdivision in the individual income tax or prooerty ta�refund <br /> instructions instead of on diosc fonns. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or contidential. Upon his iLrther request,an individual who is the subject of <br /> stored private or publ ic data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of die content and <br /> meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispufe or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require[he requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of <br /> the date of the reques[,e�duding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he caimot comply 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 public or private data <br /> concerning himself. To exercise this right,an individual shall notity in writing the responsible authority describing the nature ofthe disagreement.The <br /> responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. 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 responsible aidhority may be appealed pursuant to the provisions of the administrative 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 pern�it or license from the City of Orono or any of its departments may rec�uire you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> l. "I'he information you furnish will be used to deterniine 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 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 /> -�-,�.�5 I� k /-�-�� � �,� c; �_�� �; � <br /> First A4iddle Last <br /> `� � �f c� M � f�l ti ��IL�4 �'�'2, <br /> A��r�55 <br /> '�r+-�'-�—zv�}'j r1�� !� �S-� 3 � a 5�.� - y �� -� 5/ l� <br /> City Sts�te "I,ip Phone <br /> I understand my rights as stated above. <br /> _ __ �,- `- <br /> ,—_..____f- / <br /> �/���� /� ,-, <br /> �'i�cX . L-C� � C..� � <br /> Signaturc <br /> �2 <br />