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A <br /> r r <br /> Sea 13.04 RIGHTS OF SUBJECTS 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 forth in this secdon. <br /> Subd.2. InformaHon required to be given individual. An individual asked to supply private or co�dendal data concerning himself <br /> shall be informed of: (a)the pu�pose and intended use of the requested data within the collecting state agency,political subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence uising from his supplying or <br /> refusing ro supply private or confidential data;and(d)the identiry of other persons or endaes authorized by srate or federal law to receive the data. <br /> T6is requirement shall not apply when an individual is asked to supply invesrigative data, pursuant to secdon 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissior►er of revernre mav olace the noace rewired uruler this subdivision in the individual income tax or oronerN taz refund <br /> instructions 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 <br /> subject of stored data on individuals,and whether it is class�ed as public,private or confidential. Upon his further request,an individual who <br /> is the subject of stored private or public data on individuals shall be shown the data without a�ry charge to him and,if he desires,shall be informed <br /> of the content acud meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be <br /> disclosed ro him for six months thereafter unless a dispute or acdon pursuant�this secaon is pending or addiaonal data on the individual has been <br /> collecred or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. <br /> The responsible au�flority may require the requesting person to pay the actual costs of maldng,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any request iqade�rsuant to this subdivision,or within five days <br /> of the date of the request,ezcluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compiy with <br /> the request within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request, <br /> excluding Saturdays,Sundays and legal holidays. <br /> Subd.4. Proce�are when data is not accurate or compkte. An aidividual may contest the accuracy or completeness of public or <br /> private data co�erning himself. To exercise this right,an individual shall notify in writing the rosponsible authoriry describing the nature of the <br /> disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccarate or i�omplete and attempt to notify <br /> past racipients of inaccu�te or i�omplete data,uicluding recipients named by the indiv,idual;or(b)notify the individual that he believes the data <br /> to be conect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disciosed data. <br /> The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating <br /> to 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 <br /> request for a permit or license from the Gity 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 fumish 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 shaced 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 /> �/�'k� W 1 L��nrrv� (��ZE t,c� — <br /> � First Middle I,ast <br /> $�� 1/V�l��"w�rF-'i LIJ • <br /> Address <br /> ls�� �P-�.I�EK m� • 5"S4LZ- Svf-o��' <br /> Ciry State Zip Phone <br /> derstand my righ stated abo . <br /> gnature <br /> 6 <br />