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. • � Sec.13.04 RIGIiTS OF SUBJECTS OF DATA + , Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given individual. M individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and inte�ed use of the requested data within the collecting state agency,political subdivision,or siatewide system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the idendry of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of rever►ue mav olace the notice reauired under this subdivision in the individual income tax or orooertv tax refund instiucrions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the � subject of stored data on individuals,and whether it is classified as public,private or confidendal. Upon his further request,an individual who is the subject of stored private or public data on i�ividuals shall be shown the data without any charge to him and,if he desires,shall be informed of the conunt and meaning of that data. After an individual has been shown the private data and informed of iu meaning,ihe data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this secdon is pending or additional data on the individual has been ' collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesdng person to pay the actual costs of maldng,certifying,and compiling the copies. The re�ponsible authoriry shall comply immediately,if possible,with any request made pursuant to tkus subdivision,or within five days � of the date of the request,excluding Saturdays,Sundays acxi legal holidays,if immediate compliance is not possible. If he cannot comply with i the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request, excluding Saturdays,Sundays and legal holidays. i I Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or i private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the i disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or i�omplete and attempt to noafy past recipients of inaccurate or incomplete data,i�luding recipients named by the i�ividual;or(b)notify the i�ividual that he believes the data ; to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the respoasible authoriry may be appealed pursuant to the provisions of the adminisorative procedure act relating , to contested cases. i DATA PRIVACY ADVISORY 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�ity of Orono or any of its departments may require you to furnish certain �I 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 j 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. - First Middle Last Address City State Zip Phone I understand m rights as stat �� Signature - � �1�/`— � as�. . �>'��'z" 6