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� <br /> ' � <br /> Sec.13.04 RIGATS 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 forrh in this secdon. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial data conceming himself shall <br /> be informed of: (a)the purpose and intended use of the requested data wi[hin the collecting'state agency,policical subdivision,or statewide system; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply <br /> private or confidendal data;and(d)the identity of ocher persons or enrides authorized by state or federal law to receive the data. This requirement shall <br /> not appiy when an individual is asked to supply invesrigadve data,pursuant to secaon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or propem tax refund <br /> instruccions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is rhe subject <br /> of stored data on individuals,and whecher it is classified as public,private or conFidendal. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data wichout any charge to hirn and, if he desires, shall be informed of the content <br /> and meaning of�hat data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hun for <br /> six months thereafrer unless a dispute or action pursuanc to this secrion is pending or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the actual costs of makine, cerafying,and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible,with any request made pursuant to this subdivision,or wi[hin five days of <br /> the date of the request,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within[hat ticne,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays, <br /> 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 private <br /> data concerning himseif. To exercise this right,an individual shall norify in wridng the responsible authoriry describing the narure of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to norify past recipients of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data <br /> in dispu[e shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant to the provisions of the admuustrarive procedure act relaang to <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 that 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 /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the pemut or license requested. <br /> 2, You may refuse to supply data, but refusal may require that the City deny the permit or license. <br /> 3, T'he information may be shared with other local, state or federal agencies to the extent necessary to process <br /> the permit or license. <br /> 4. If your requested permit 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 /> (. Your full name is required to process this application or permit. j <br /> �� ; � i— ' � -, ��� , <br /> � ; <br /> . � ,����� ��� ,ti.�a�'� ;� ' �' ,� �/i✓ v �'� <br /> Middle Last ` <br /> First �/�� /� � l,.Ii� � �� R /��(!o/ ��l �G'���� V G/Z�l �I - <br /> � <br /> Address � �� ����� �� �� �� �� ���� � <br /> ���'-� L <br /> City State Zip Phone <br /> I understand ;ny rights as stated above. <br /> � ` %� �� � �%�� <br /> G �'�' <br /> Signa re <br /> � <br />