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` i � � f Sec.13.04 RIGHTS OF SUBJECTS OF DATA ' Subd.1. Type of data. Thc rights of Individual on whom 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 rnntidential data concerning himself shall be informed ot: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivlsion,or statewlde 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 suppiy private or confidential data;and(d)the identlty of other persoas 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,pursusnt to section 13.82,subdivision 5,to a law enforcement ofticer. The commissioner o(revenue mav olace the notice reautred under this subdivision in the individual income tax or aroaertv taz refund instructions instead ot on those torms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,aad whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or publfc data on(ndividuais shall be shown the data without any charge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months therea[ter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or c�eated. The responsible authority shall provide rnpies of the private or public data upon request by the individual subject of the data.The responsible authorlty may require the requesting person to pay thc actual rnsts of maWng,certifying,and compiling the copies. The responsible authority shall rnmply immediately,if possiblc,with any requcst made pursuant to this subdivision,or within tive days of the date o(the request,exctuding Saturdays,Sundays and legai holidays,if immediate rnmpliance is not possiblc.lf hc cannot comply with 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,exciuding Saturdays,Sundays �nd legal holidays. Subd.4. Procedure when data ts not accurate or complete. An Individual may rnntest the accuracy or completeness of public or privstc data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature oCthe disagrcement.The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or inrnmplete and attempt to notify past recipients of inaccurate or inrnmplete data,including recipients named by the individual;or(b)notity the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included wlth the disclosed data. The determination of the responsible authority 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 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(availabie upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. L�-'1AILfZS S ��✓ \Dl First Middle Last q � � Q X _. Address - QAo�.v�►�.s�.ev�. I�� .�31 l 9 S Zq L S�/� City State Zip Phone I understa y rights as stated above. Signa