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Sec.13.04 RIGHTS OF SUBJECTS OF DATA ' <br /> ' !Subd.1. Type of data. The rights of individual on whom the data is stored ar to be stored shall be�s set forth ia this section. <br /> Subd.2. lnformation required W be given individual. An individual asked to supply private or confideatial data conceraing himseif shall ire <br /> informed of: (a)the purpose and iatended use of the requested data within the collecdng state agency,polidcxl subdivision,or statewide system;(b) <br /> whether he roay refuse or is legally required to supply the requested data;(c)aay Imown consequeace urising from his supplying or refusing to supply <br /> private or coafidential data;and(d)the identity of other persons or entities authorized by state or federat law to receive the dam. This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to secden 13.82,suhdivisian 5,to a law enforcemeat officer. <br /> �he commissioner of revenue mav place the notice reauired under this subdivisioa in the individaal iacame ta�c ar eronertv tax refund <br /> instructions instead of on those farms. <br /> Subd 3. Access ta data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or confideadal. Upon his fiirther request,an individual who is the subject of <br /> sWred private or pubGc dam on individuats shall be shown the data without any charge to him and,if he desires,shall be informed of the content and <br /> meuniag of that daCa. After an[adividnal has been shown the private data aad inFormed of its meaning,the data need aot be disclosed to him for six <br /> manths thereafter untess a dispute or action pursuant to this secdon is pending or addidonal data on the individua[has beea coUected or creared. The <br /> respoasible authoriry shall provide copies of the private or public duta upon request by the individual subject of the data.The responsible authority may <br /> require the requesdag ptrson to pay the actual costs of making,ceRifying,and wmpiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant W this subdivisian,or within five days of the <br /> date of the request,excludin�SaNrdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that dme,he shaU so iaform tfte individual,and may have aa addi6onal five days wiUtin which to comply with the request,exclnding Sadudays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or campiete. Aa individual may coatest the accuracy or completeaess of pub(ic ar pdvate data <br /> conceming himse[f.To exercise this right,an individual shaU notify in writing the r�ponsible authority describiag the nature of the disagreement The <br /> responsible authority shall withia 30 days either: (a)correct the dam found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccurs►te or incomplete data,including recipients named by the individual;or(b)aotify the individu�l that he believes the data W be cartect Data in <br /> dispute shap be disclosed only if the individual's statement of disagreement is included with the disclosed dasa. <br /> The determinadon of the responsible authority may be appealed pursuant m the provisions oF the administ�ative procedure act reta6ag W <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 th�t your request <br /> for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> conftdential information. <br /> You are notified that: <br /> 1. The information you fumish will be used to determine your qualification for the pemut 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 informarion 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 rnay become <br /> public. <br /> 5. You have certain rights under M.S. 13.a4(available upon request)to review private data on yourself. <br /> 6. Your full name is required W process this applicadon or permit. <br /> �� N �n,P►PS <br /> Flrst Middle Last <br /> �o � H ,v o,�-fh S m�r�� � 2. <br /> aaar� <br /> ��cv Nv w, � s�.��� 95� -y�Z-���� <br /> Citq State Zip Phone <br /> I understand m r' hts stated abo . <br /> \ <br /> Signature <br /> 10 <br />