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� Sec.13.04 RIGHTS OF SLJB.TECTS OF DATA Subd. 1. Type of data. The righcs 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. r1n individual asked to suppiy private or confidendal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the coliecting'state agency, polidcal subdivision,or statewide system; (b)whether he may refuse or is leeally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply priva�e or confidendal data;and(d)the identiry of other persons or entides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesagaave data, pursuant to secrion 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of revenue mav place the noace required under this subdivision in the individual income tax or propertv tax_refund insuucrions instead of on those forms. 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, and whe[her it is classified as public, priva[e or confidential. Upon his furthec request,an individual who is the subjecc of stored private or public data on individuals shall be shown the data wi[hout any charge to him and, if he desires, shall be informed of the content and meaning of tha[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 thereafter unless a dispute or action pursuant to this secaon is pending or addiaonal data on the individual has been collected or creaced. The responsible authority shalt provide copies of the private or pub(ic data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costs of making, cerrifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compiiance is not possible. If he cannot comply with the request within thac time,he shail so inform the individuat,and may have an addidonal five days wi[hin which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure w6en data is not accurate or complete. An individua(may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days eirher: (a)correcc the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by the individual; or(b)notify 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 with the disclosed data. The determination of the responsible au[horiry may be appealed pursuant to the provisions of the administrarive procedure act rzlating to concested 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 pernvt 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 refusai may require that the City deny the pernut or license. 3. The information may be shared with other local, state or federal agencies ro 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. $, 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 viiddle Last Address C�ry State Zip Phone I understand my rights as stated above. Signature