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�4 Sec.13.04 RIGHTS OF SUBJECTS OF DATa Subd. 1. Tvpe of data. 'Ihe righ[s oF individual on whom the data is storc3 or co be scored shall be as sec forch in this secrion. Subd.?. Information reqtrired to be given individual. An individual ask�to supply private or confidendal data conceraing himsdf shall be informed af: (a)the purpose and inrtnded use of the ttquested dara v.i�in the collecring Ytare agency, polidcal subdivisian,or sratcwide rysum; (b)whecher he may refuse or is legally required to supply che requested dan:(c)any l�own consequence arising from his supplying or refusing to supply privace or conndendal dara;and(d)the idenriry of other pecsoas or enuacs a�[horized by stato or federal law to rective the data..This requiremenc shall not apply when an indir•idual is asked to supply invesa¢adve dard,pursusa�to secaoa 13.82, subdivision S, to a law enforeement o�cer. The commissioner of revenue nav place the nodce reauired erd-r chis subdivision in the individual income tax or propertv rax refund instruccions instead of on those forms. Subd.3. ?.ccess to data by indir-idual. Upon request to a resgoosible aec_^.ority,an individual shall be informed whether he is[he subjec[ of s�ored data on individuals,and whe�her it is ctassified as pubtic,priva�.or confid�r.rial. Upon his furcher request, an individual who is the subject of s[oted private or public data on individuals shall be shovm the dara wi�.out any c"na�e to him and;if he desires, shall be informed of the content and meaning of thac daca. After an individual has been shawn ehe priva��aci and in:ormed of ics meaning,the dara need not be disclosed to him for six mon[hs chereai[er unless a dispute or acrion pursuant to �his secdon is��nding or addiaonal data on the individual has been collected or created. The responsibla auehoricy shall provide copies of[he private oc public dac�ucon requ�:by the individual subject of ihe data. The responsible auchoriry may require che requesring penon to pay the actual cosu of makinz,cer�Jing,and compiling the copies. The responsible au�horiry shall compiy immediacety, if possible,wirh any r_quesc made pursuant to this subdivision,or wichin five days of the date of�he reques�,excluding Sacurdays,Sundays and legal holidays,ii icamedi�ce comptiance is not possible. If he cannoc comply with the reques� wiehin chac dme,he shall so inform che individual,and may have an addicoa;l five days wichin which to comply wich the request,exeluding Saturdays, Sundays and legal holidays. Subd.4. Pracedure whea data is not accurate or complete. ?.n indivitual may contest the accuracy or completeness of public or pri�•ate dara conceming himseif. To exercise chis riehG an individual shall nodfy ia wridng ce responsible authoriry describing che natttre of the disagteement. The responsible au�horiry shall within 30 days either: (a)correcc[he daa tcund to be inaccurate or incompieu and aaemp�to nodfy past recipiencs of inaccurace or incomplete daca, including recipiencs named by�he individual;or(b)eodfy the individual that he believes the dara to be correct Data in dispu�e shall be disclosed only if the individual's sracemenc of disagr:=�en�is i�cl•_ded with che disclosed data. The decerminarion of the responsible auchoriry may ba appeal=d pursuaa�to the provisions of[he admiaistrarive procedum act reladng to contested cases. . DATA PRIV�CY AD�'ISORY In accordance with M.S. 13.04, Subd.2, "Ri�hts of subjects oi data", we would like to inform you that your reauest for a permit or license from the Ciry of Orono or any of iU deparments may require you to furnish certain private or confidential information. You are notified that: 1, The information you fumish will be used to de:ermine�'our qualification for the permit orlicense requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3, The information may be shared wi[h o�her local, stace or federal a�encies to the excenc necessary to process the permi[ or license. 4. If your requested permit or license requires Council action to approve, some information may become . , public. �, You have�certain rights under M.S. 13.04 (available upon request) to review private data on yourself. 6, Your full name is required to process this zpplica�ion or perm.i�. .�r r�.. —�c.��. ��-�—rc�--►'� Finc I ` �i' e Lasc �'��G� f l� E � �� r /t.� �l la'�C,t_t � ?.ddress n +� p � ��-�"� �� %C']� � Y l r l�` i��\iV ��(" —1.J / Ciry Stam Zip Phone I underst �a stated above. t Signatu � �