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Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.i. Type of data. The rights of individual on whom t6e dats is stored or to be stored shsll be as set forth io this section. Subd.2. Informatlon required to be glven individual.An individual asked to supply prlvate or coeBdeoHsl data coocerniog 6imselishall be ioforroed oE (a)the purpose and 9ntended use of t6e requested dats wlthin the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the reqaested data;(c)any known consequence arisiog from his supplying or refusing to snpply private or confldendal dats;and(d)the ideotity of other persons or enHHes authorized by state or federal law to receive the data T6is requiremeot shsll not apply when an iodividual is asked to supply investigaHve data,pursaant to sectlon 13.82,subdivision 5,to a Isw enforcemeot offlcer. The commissioner of revenue mav olsce the noHce reauired uoder t61s subdivision in the individnal income tax or orooertv tax reNnd instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,so individual s6a11 be informed whether he is the sub)ect of stored data on indlviduals,and whether it is classifled as publlc,private or confldential. Upon his further request,ao individual who is the subject of stored private or public dats oe iodividuals shsli be showo the data without any cherge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown t6e private data and ioformed of 1ts meaeing,the dsta need not be disclosed to 6im for si�c moeths thereafter unless a dispute or acHon pursusnt to t6is secdon is pending or additional data on the individual has been collected or created. The responsible aut6ority shsll provide copies of the private or pablic data upoo request by the individual subject of the data.The responsibie autdority may require the requestlng person to pay the actuel costs oi maldng,certifying,and compiling the copies. The respoosible authority shall comply immediately,iipossible,with any request made pursaant to this subdivision,or wlthin 8ve days of the date of the request,excluding Saturdays,Snndays and legal6olidays,if immedlate compliance is not possible.If he csonot comply wit6 the request within that hme,6e shsll so iniorm the individoal,and msy have sn additiooal�ive days w9thin which to comply with the requesy eacinding Saturdays,Sandays and legal6olidays. Subd.4.Procedure when data is not accurate or complete.An individual may contest the accurscy or completeness of public or private data concerning himself.To ezercise this right,an individual s6s11 ooHfy 9n wridng the responslble authorlty describing the nature of t6e disagreemeow The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past reclpients of inaccurate or incomplete data,including recipients named by the individual;or(b)noHfy the indivldual that he believes the data to be correct. Data in dispute shsll be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinaHon of the responsible authority may be appealed pursuant to the provisions of the administraHve procedure act relaNng to contested cases. DATA PRIVACY ADV[SORY In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified 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 City deny the permit or license. 3. The information may be shared with other local,state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. 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 application or permit. ��/f'� �/1/G-//� C.�Ck�1��fA� First Middle Last Address City State Zip Phoee I understand my rights a a d above. S re