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� <br /> Sec.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 secaon. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or co�de�dal data concerning himself <br /> shall be informed of: (a)the purpose and intended use of the requested data within the collecdng state agency,poliocal subdivision,or statewide <br /> rystem;(b)whether he may refuse or is legally required to supply the requested data;(c)any lrnown consequence arising from his supplying or <br /> refusing co suppiy private or confidendal dara;and(d)the idenary of other persons or enaaes authorized by srate or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secaon 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> The commissioner of revenue mav place the notice reauired under this subdivision in the individual income taz or orooertv tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsibie 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�dential. Upon his furrher request,an individual who <br /> is the subject of stored private or public data on individuals shall be shown the data without any char�e to him and, if he desires,shail be informed <br /> of che content and meaning of that data. Afrer an individual has been shown the private data and infocmed of its meaning, the data need not be <br /> disclosed to him for six months thereafter unless a dispute or action pursuant to this secaon is pending or addirional data on the individual has been <br /> collected 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 auchoriry may require the requesring person to pay the actual cosu of making,cerrifyin„ and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possib(e,with any request made pursuant to this subdivision,or within five days <br /> of the date of the request,excluding Sacurdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply 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. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or <br /> private dara concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the <br /> disagreement. The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplete and attempt to nodfy <br /> past recipients of inaccurace or incomplete data,including recipients named by the individual;or @)norify 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 determinadon of the respoasible authority may be appealed pursuant to the provisions of the adminiscraave procedure act relaang <br /> ro 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 City of Orono or any of its departments may require you to furnish certai.n <br /> private or confidential information. <br /> You are notified [hat: <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) to review private data on yourself. <br /> 6. Your full name is required to process this a�plication or permit. I � <br /> � I '���v � � r-( �_ �:�n��(r���_7l���1 L� <br /> i�,��1�-fZi.L 2 �?-��� � S <br /> First Middla <br /> Last <br /> ��_t� I C' .Prb?.�SC`r�J ' 'i� `�___�'�::' I Z� �� <br /> �dress <br /> M �►«- Ni N ���c�� �s -�����- �,��3 <br /> C�ry �State Zip Phone <br /> I understand m rights as stated above. <br /> Signatu ' <br /> 6 <br />