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Sec.13.04 RIGHTSOFSUBJECTSOFDATA Subdivision 1. Type ojdat¢ The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. � Subd.2. Information required to be given indivlduaL An individual asked to supply private or confidential data concerning himse[f shal!be informed of.• (a)the purpose and rnterrded use of th¢requested data within the collecting state agency,political subdivision,or statewide system;(b)whether he may refuse or is legally required to suppFy the requested data;(c)arry known consequence arising from his supplying or sefusing to supplyprivate or confidential da1a;and(d)the identity ol o�her persons or entities authorized by state orfederal!aw to seceive the data. This requirement shall not apply whe»an individual is asked to supply imestrgative data,pursuant to section 13.82, subdivisron 5, to a/aw enforcement o�cen The commrssioner ofrevemte mav place the notice required under this subdivision in the individual income tax or nsonerlv tax refund ixstructions instead ot on those torms. Subd.3.Access to data by lndividuaL Upon request to a responsible authority,an indivrdual shall be injormed whether he is the subject of stored data on rndividuals,and whether it is c[assifred as public,private or confrdential. Upon his further request,an individual who is Jhe subject of stored private or public data on individuals shall be shown the data without a�ry charge to him and,rf he desires,shall be informed oj the content and meaning of that data. Ajter an individual has been shown the prrvate data and rnformed of its meaning, the data need not be disclosed to him for six months thereafter un[ess a dispute or action pursuant to this section is pending or additional data on the individua!has been collected or created. The responsible aulhority shall provide copies of the private or public data upon r¢quest by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,cert�ing,and compiling the copies. The resporrsible authority shall comply immediately,if possible,with arry request made pursuant to this subdivision,or within frve days ojthe date of the request,excluding Saturdays,Surrdays and legal holidays,rf immediate compliance rs not possible. I,f he cannot comply with the request within that time,he shall so rnform the individua[,and may have nn additional frve days within.whrch to comp[y with the request,excluding Saturdays,Sundays and legal holidays. Subd.4.P�ocedure when data is not accurate or complet�An individual may contest the accuracy or completeness ofpublic or private data concerning himse[f. To exercrse this right, an individual shall not�rn writing the responsrble authority describing the nature oj�he disagreement. The responsible aulhority shall within 30 days either: (aJ conect the data found to be inaccurate or rncomplete axd attempt to not� past recrprents of inaccurate or incomplele data,including recipients named by 1he individual;or(b)nol�the indrviduallhat he believes the data to be correct Data in dispute shal!be disclosed only rf the rndividual's statement of disagreement is included with the disclosed data. The determinatron of the responsible authority may be appealed pursuant to the provisions of the administrative procedure acl re[ating to contested cases. DATA PRIVACYADVISORY InaccordancewithM.S.13.04,Subd.2,"Rightsofsubjectsofdata';wewouldliketoinformyouthatyourrequestforapermitorlicerrse from the City ojOrono or arry ojits deparhnents may require you to furnrsh certain private or confrdential information. You are notrfied that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the Crty derry the permit or/icerue. 3. The injosmation may be shared with other local,state or federal agencies to the extent necessary to process the permit or license. 4. I,f'your requested permit or licerue requires Council action to approve,some informalion may become public. 5. You have certain rights under M.S. 13.04(see jollowixg page)to revrew private data on yourself. 6. Your full name is required to process this applicarron or permit. PLEASE PRINT Flrst Middle Last Address City State Zip Phone I understand my rights as stated above. Signature 10