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� Sec.13.04 RIGHTS OF SUBJECTS OF DATA � Subd. 1. Type of data. The 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 ro suppty private or confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecdng state agency,polidcal subdivision,or statewide rystem;(b)whether he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing tfl supply private or coofidential dara;and(d)the idenrity of other persons or endaes authorized by srate or federa!law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income taz or orooertv tax refund instrucdons mstead 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 whether it is classified as public,private or co�denrial. Upon bis further request,an individual who is the subject of s[ored private or public data on individuals shall be shown the data wi[hout any char�e to him and, if he desires, shall be informed of the contznt and meaning of that data. Afrer an individual has been shown the private data and informed of iu meaning, the data need not be disclosed to him for six monuu thereafrer uriless a dispute or action pursuant to this section is pending or addidonal data on the individua!has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the actual costs of making,certifying,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 compliance is not possible. If he cannot comply with the request wi[hin that cime, he shall so inform the individual,and may have an additional 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 dara concerning himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shal]within 30 days either: (a)coaect the dara found to be inaccurate or incomplete and attempt to nodfy past recipienrs of inaccurate or incomplete dara,including recipienu named by the individual;or(b)nocify 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 inc(uded with the disclosed data. 'Ihe determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the administraave procedure act relaan, 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 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 [hat 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 pemut or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain ri;hts 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. / �\C�� v �t ,v` _,' ,,,�,�'G 1 � � Last d ��v� � /1�1� , s�-�/ �/,� ��5 08l� C�ry State Zip Phone I understand s ate a e. I r , G'J ` 6 �