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. ,r w <br /> .� <br /> � <br /> Sec.13.04 RIGHTS OF S[JBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of indi�idual oa whom the data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Informatlon required to be gtven mdivfdual. An individual asked to supply private or confidential data conceming himself <br /> shall be info�of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to svpply the requested data;(c)any Irnown consequence arising from his supplying or <br /> refusing to supply private or confidential data;and(d)the identiry of other peisons or emities audiorized by state or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked w supply investigadve data, pursuant to secdon 13.82, subdivision 5,to a law <br /> enforeement officer. <br /> The commissioner of revenue mav nlace the nouce rewired un8er this subdivision in the individual income taz or nrooertv tax refund <br /> instructions instead of on d�ose forms. <br /> Subd.3. Access to data by individual. tipon 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 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 d�e data without any charge to him and,if he desires,shall be informed <br /> of d►e content and meaning of that data. After an indi�idual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six months thereafter uniess a dispure or action pursuant to this secdon is pe�ing or additional data on the individual t�as been <br /> collected or created. The responsible authority shall pro�-ide copies of�e private or public data upon request by the individual subject of the data. <br /> The responsible authoriry may require the requesting person to pay the actual cosu of maldng,certifying,and compiling the copies. <br /> The resnonsible authoriry stiall comply immediately,if possible,widi any request made pursuant to this subdivision,or within five days <br /> of the date of the requesc,excluding Saturdays,Sunday�s and legal holidays,if immediate compliance is not possible. If he cannot comply wid� <br /> the request within that time,he shall so inform the individual,and may have an additional 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. M individual may cqntest the accuracy or completeaess of public or <br /> priva�data wncerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the <br /> disagreemem. The responsible audioriry shall within 30 days either. (a)correct the data found bo be inaccarate or incomplete and attempt to notify <br /> past recipieras of iaaccurate or incomplete daffi,including recipients named by the iadividual;or(b)notify the individual that he believes the data <br /> w be conect. 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 responsible authorin-may be appealed pursuant to the provisions of the admieistrative procedure act relating <br /> w wntested 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 �in•of Orono or any of its departments may require you to furnish certain <br /> private or confidential information. <br /> You aze 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 pemut or license. <br /> 4. If your requested permit or license requires Council acdon to approve, some information may become <br /> public. <br /> 5. You have certain rights under VI.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 /> �,� c �c��' <br /> First iddle Last <br /> ���'/Y s5�✓v�� 5�1,�-�- ��7�--- -- <br /> Address <br /> �j•�.�.^'" �t�, � .�3 d� _ <br /> City Staie Zip Phone <br /> I understand my rights as stated above. <br /> Signature <br /> 6 <br />