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� i Sec.13.04 RIGHTS OF SUBJECTS OF D�T?, Subd. 1. Type of data. The righcs of individuai on whom c�e dara is storrl or to be stored shall be as set forch in this secaon. Subd.3. Infocmation reqtirired to be givea individual. �1n icdi��idual askd w supply privace or confidendal data conceming himself shall be informed of: (a)[he purpose and incended use of[he requested dara wi�in the eolleccing�tate agency,poliacal subdivisian,or sratewide sysum; (b)whecher he may refuse oY is legally required to supply che requested dat►:(c)any Imown eoasequence arising from his supplyiag or refusing to supply privace or connde:.�al dara;ar.d(d)the idendry of ocher persons or endaes xachoriz:d by srate or federsi law to receive the data..7his requiremen�shaIl not apply whan aa ir.dividuai is asked to supply invesdgaave dara,pursu_::co seccoa 13.82,subdivision 5,to a law enforcemenc o�cer. 'Iha conmissioner of revenue mav vlace che norice rauired nrd-r�his subdivision in the individual income tax or aronertv tax refund instructions instead of on those forms. Subd.3. Access to data by iadi�idual. Upon request to a r_sronsible aerhoriry,an individual shall be informed whether he is the subject oF swred data on i:.dividuais,and whecher it is classified as public,privam or confider.rial. Upon his further requesc,aa individual who is the subjecc of storzd private or public dara on individuais shali be shown che dara wiu.ouc any c'n�e to him and;if he desires,sLall be informed of the concent and meaning of c�ac dara. Afcer an individual has been shown ehe priva��an and ia:ormed of ics meaning,the data need not be disclosed to ti�n for six monchs[her_a=�r unless a dispuce or acdon pursuanc to[his sec6on is t:lding or addidonal data on the individual has been coilected or creaced. The responsible a�*?�oriry shail provide copies of the privace or public da�c�on requa:by che individual subject of che data. The responsible authoriry may require che requesdng person to pay the accual cosu of makinz,ce._:;ing,ar.d compiling the eopies. The responsible auchoriry shall comply immediacely,if possib!_,wich any r_quest made pursuant to this subdivision,or wichin five days of the date of che re�::esc,excluding Saardays,Sundays and legal holidays,ii ir,.mediam compliance is not possible. If he cannot comply with the requesc wichin thac time.�e shall so infocm�he individual,and may have an addicecal Five days wiehin which to comply wich the request,excluding Saturdays, Sundays and legat holidays. Subd.�. Procedure when data is not accurate or complete. An indivituxl may contest che accuracy or completeness of public or private data conceming rirnself. To exercise chis right,an individual shall nodFy ia wriang�;e responsible authoriry describing�he nature of the disagreemeac. The responsible x:��horiry shall wi�hin 30 days either: (a)correcc[he daa fcund to be inaccurat�or incomplece and attempt to nodfy past recipiencs of inaccurate or incorapiete data, including recipients named by the individi��l;or(b)�odfy ehe individual that he believes the data to be eoaec�. Da�a in dispuce shali te disclosed only if che individual's stacemanc of disagree�enc is i.c:nded with che diselosed data. 'fhe te;e:minarion of the responsible auehoriry may be appea:e3 punuacc to che provisions of the admicusaarive procedure act reladng to contesced cases. . � � DATA PRIVACY AD�'ISORY In acco:��ce wich M.S. 13.04, Subd.2, "Rights of subjects oi data",we would like to inform you that your request for a permit o; license from the City of Orono or any of i� deparmen[s may require you to furnish certain privace or confidential i:formation. You are notified that: i, The informacion you furnish will be used to de:ermine}'our qualification for the permit or license requested. 2, You may refuse co supply data, buc refusal nay require that the Ciry deny the permit or license. 3, The information may be shared with other loc�l, state or federal agencies to the excent 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 (a�ailable upon request) to review private data on yourself. (, Your full name is required to process this aoplica[ion or permic. Fint �fiddle Lasc Address • Ciry Stace Zip Phone I undecstand my ri;hts as stated above. ` �� Signamr: