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_ - } � - � Sec.13.04 RIGH'I5 OF S[JBJECTS OF DATA S�bd. i. Type of data. 'Ihe rights of individual on w6om the data is sWred or to be stored shaU be as set focth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked w supply private or confidential data conceming himself shall be informed of: (a)the puipose and incended use of the requested data within the collecting§tate agency,poHtical subdivision,or statewide sysoem; (b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or nfusing to supply privau or confidendal data;and(d)the idenairy of other persons or entities authorized by state or fedetal law to receive the data. This requirement shall not apply when an individual is asked to supply investigadve data,pursuant to section 13.82,subdivision 5,to a law eaforcement officer. The commissioner of revenue mav nlace the nodce reauired under this subdivision in the individual income taz or oropern taz refund inst�ucdons 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 confidenaal. Upon his further request,an individual who is the subject of stored private or public dara on individuals shall be shown the data without aay charge to him and,if he desires, shall be informed of the content and meaning of d�at data. After an individua!has been shown the private data and informed of its meaning,the data need not be disclosed to him for siz months theceafter unless a dispuu or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authoriry s6a11 provide copies of the private or public data upon request byahe individual subject of the data. The responsible authoriry may require the roquesting person to pay the actual costs of making,cerBifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,ezcluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addiaonal five days within wluch to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exetcise this right,aa individual shall notify in writing the responsible authority describing the naaire of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccucate or incomplete a�attempt to nodfy past recipients of inaccurate or incomplete data,including recipients named by the individual; or(b)notify the individual that he believes ihe 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 determinarion of the responsible authority may be appealed pursuant to the provisions of the administcaave procedure act relatiag to contested cases. 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 City of Orono or any of its departments may require you to furnish ceRain private or confidential information. You aze 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 shazed 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. 0 First M' dle �s� S Ad ress � �v� City State Zip Phone I unde�tand my ri ts as stated above. si