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� ? Sec.13.04 RIGIi'TS OF SUBJECTS 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 req�rired to be given individual. An individual asked to supply private or confidential dara conceming himself sha11 be informed of: (a)the purpose and intended use of the csquested data within the collecting�tate agency,political subdivision,or sratewide sysum; (b)whether he may refuse oY is legally required to supply the requested data;(c)any imown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the idenriry of o[her persons or enuaes authorized by stace or fede�al law to receive the data. This requirement shall not appty when an individual is asked to supply invesrigadve data,pursuant to secdon 13.82,subdivision 5,to a law enforcement o�cer. The commissioner of revenue mav alace the nodce required under this subdivision in the individual income taz or aropertv tax refund instcuctions 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 whe[her it is classified as public,private or confidenaal. Upon his further request,an individual who is the subject of stored private or pubtic data on individuals shall be shown che data wi[hout 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 meaniag,the data need not be disclosed to him for six months thereafur nniess a dispute or acdon pursuanc to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the iadividual subject of the data. The responsible authoriry may require the requesang person to pay the actual costs of making,certifying,and compiling the copies. The responsible au[horiry 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 compliance is not possibie. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addiaonal 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 himself. To exercise this right,an individual shall notify in writing the responsible authority describing che nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and aaempt to nodfy past recipients of inaccurate or incomplete data, iacluding recipients named by[he 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 wirh the disclosed data. The determination of the responsible au[hority may be appealed pursuant to the provisions of the adma►istrarive procedure act reladng 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 pemut 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. First Middle Last Address Ciry Stau Zip Phone I understand my rights as stated e Signamre