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♦-. Sec.13.04 RIGHTS OF SCTB.TECTS OF DaTA • Subd. 1. Type of data. �he rights of individual on whom the data is stored or ro be stored s6all be as set fosh in this secaon. Subd.2. Information req�red to be given individual. M individual uked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and intended use of rhe csquested dara wi[h'in the collecdng State agency,poliacal subdivision,or statewide rystem; (b)whether he may refuse ot is legally required to supply the requested data;(c)any Imown coasequence arising from his supplying or refvsing to supply privau or confidendal data;and(d)the idenury of other persoas or endaes authorized by state or federal law to receive the data. This requiremeat shall not apply when an individual is asked to supply invesdgadve data,punuanc ro secaon 13.82,subdivision 5, to a law enforcement o�cer. The commissioner of te�•enue mav place the nodce rewired under this subdivision in the individual income taz or oropem ta�c refund instrucdons instead of on rhose 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 whe[her it is ctass�ed as public,priva[e or confidendal. Upon his further request,an individual who is the subject of swred peirdte or public data on individuals shall be shown dse data without any charge to him and;if he desires,shall be infocmed of the content and meaning of that dara. Afur an individual hu been shown the private data and informed of irs meaning,the data need not be disclosed ro him for six months thereaRer unless a dispuu or acaon pursuanc to[his section is pending or addidonal data on the individual has been copected or created. The responsible authoriry shall provide copies of the private or public data upon cequest by the iadividual subject of the data. The responsible authoriry may requiro the requesting person to pay the acaal coscs of making,cerdfying,and compiling the copies. - The responsible aurhoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the roquest,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannoc compty with the request within that tune,he shall so inform the iadividual,and may have an addiuonal five days within which 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 himsNf. To exereise chis right,an individual shall nodfy in writiag the responsible authoriry describing the nature of the disagreement The responsible aurhority shall within 30 days ei[her: (a)correct the data faund to be inaccunte or incomplete aad aaempt w nodfy past recipienu of inaccurate or incomplete data,including recipients named by the individual;or(b)norify the individual that he believes the data to be correct Data in dispute shall be disclosed only if the individual's stacement of disagnement is included with rhe disclosed data. The deurminadon of the responsible auehority may be appealed pursuanc to the provisions of the administradve procedure act relaaag to contesud 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 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. � �- .,e,�..� G�-� r 1 c .� � cf� g�� MiddIe Last . � 3��! s�f�L, �! /o-� •--� - Address , L1—'r� �_�/� J�,c./ ��J � 1 ��7 �7� / 2�S Ciry State Zip Phone I underst d my rights as stated above. Sig ce _