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� Sec.13.0A RIGHTS OF SUBJECTS OF DATA Subd. l. Type of datm. The rights of individuai on�vhom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himse(fshall be informed of: (a)the purpose and intended use of die requested data within the coliecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or rofusing to supply private or contidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive tlie data.This requirement shal l 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 revenue mav nlace the notice required under this subdivision in the individual income tax or proper ta�refund instructions instead of on those forms. 5ubd.3. Access co data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classitied as publ ic,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,if he desiros,shall be informed of the content and meaning of that data. After oii individual has bcen shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been coUecced or created. The responsible authoriry shall provide copies of the private or public data upon request by the iadividual subject of the data. The responsible suthoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of the date of the request,e�ciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [f he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which ro comply with the request,excluding Saw�days, Sundays and legal holidays. S ubd.4.Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data conceming himsel£ To exercise this right,an individual shall notity in writing tlte responsible authority describing the nature of the disagreement.'Che responsible authoriry shall within 30 days either. (n)cortect the data found to be ii�accurate or incompiete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bel ieves the data to be wrrect. Data in dispute shall be disclosed only if the individual's statement of disagreemont is included with the disclosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we would like to inforni you that your request for a pem�it 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 ntay be shaced with other local, state.or federal agencies to the e�ctent 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 ri�hts under Ivt.S. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or perrnit. First �tiddle LHst Address Cily 5tate 7_ip Phone I understand my rights as stated above. . Signaturc Reset Form 32