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Scc.13.04 RIGHTS OF SUBJGCTS OP'DATr� <br /> Subd. l. Type of data. The ri�hts of individual on�vhom the data is stored or to be stored shall be as set forth in this section. <br /> � <br /> Subd.2. Infonnation required to be�iven individuaL An individual asked to supply private or cont5dential data concerning himselfshall be <br /> informed of: (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may retuse or is legally required to supply the rcquested data;(c)any kno���n consequence arising from his supplying or rcYusing to supply <br /> private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to recei�e die data. This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.52,subdivision 5,to a law enforcetnent ot'ficer. <br /> The commissioner of revenue mayplace Nie notice requircd under this subdivision in the individual income fax or property tax rctund <br /> instructions instead of on those forms. <br /> Subd.3. nccess ro data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is the subject of <br /> stored dafa on individuals,and whether it is classitied as public,private or confidential. Upon his furfher request,an individual who is the subject of <br /> sfored private or public data on individuals shall be sho�vn the data without any charge to him 1nd,if he desires,shall be informed of[he content and <br /> meaning of that data. At�er an individual has been shown the private data and infonned ot'its meanin�,the data need not be disclosed to him for six <br /> months thereafter unless a dispuce or action pursuanc to this section is pending or additional data on che individual has been col Iccted or created. The <br /> responsible aulhority shall providc copies of the private or public data upon request by the individual subject of thc data. The responsible authority <br /> may require the requesting person to pay the actual costs of making,ccrtifying,and compiling the copies. <br /> Thc responsible authority shall comply immediatcly,iPpossible,with any request made pursuant to this subdivision,or���ithin tive daVs of <br /> the date of the request,e�cluding Saturdays,Sundays and legal holidays,il'immediale compliance is not possible. If he cannot comply«�ith khe request <br /> within that time,he shall so inf'orm the individual,and may have an additional five days within���hich to comply wilh the request,e�cluding S�ciuda�,�s, <br /> Sundays and legal holidays. <br /> Subd.d. Procedure when dat�is not accurate or cornplete. An individual may confest the accuracy or completeness of public or privatc data <br /> concerning himsclf. To eaercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement. The <br /> responsible authority shall within 30 dlys either (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including rec.ipients named by Ihe individual;or(h)noli'ty the individual that he belicves lhe data to be correct. Data in <br /> dispufe shall be disclosed only ifthe individual's stacement oPdisagreement is includcd�+�ith the disclosed data. <br /> The determination of the responsible authority inay be appealed pursuant to the provisions of the administrative procedure act relating co <br /> cor�;csted c��ses. <br /> DATA PRIVACY ADVIS7RY <br /> In accordance with M.S. 13.04,Subd.2,"Ri�hts of subjects oFdata",we would lilce to inform you that your rec�uest <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 /> confidential information. <br /> You are notified that: <br /> 1. The informatioii you furnish will be used to deteimine 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 inforn�ation may be shared with other local, state or federal agencies to the extent necessary to <br /> process the pem�it or license. <br /> 4. If your requested permit or license rec�uires Council action to approve, some information may become <br /> public. <br /> 5. You have certain rigllts under M.S. 1.i.04(available upon request)to review private data on yourself. <br /> 6. Your Full name is i•equired to process this application or permit. <br /> �e.,,� 1��,� A�,��4 <br /> F��-st n��ddic i.:�s� <br /> `-��° �c� ��, � <br /> f�ad�-�ss <br /> ����,.�� ('��l S��a�3 `7b3- J-3�� ���6 <br /> Citv State %ip Phonc <br /> I understand m��rights as stnted above. <br /> Sign.�ture <br /> lleset Fo: .� 3? <br />