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,� i Sec.13.0�i RIGHTS OF SUB.TECTS OF DaT�1 Subd. 1. Type of data. The rights of individual on whom[he data is stored or co be scored shall be as set forth in this section. Subd._. Informaaon reqirired to be�ven individual. A.n individual asked to supply private or confidenaal dac�concerning himself shall be infor.ned of: (a)�he purpose and intended use of che requesr�d data withia the collecdng'state a;eacy,polidcal subdivision,or sratewide system; (b)whetaer he may refuse or is legally required[o supply the requested data;(c)any lmown consequence arising from his supplyin�or refusing to supply privau or conndenrial data;and(d)the idenri[y of ocher persons or enrities authorized by sta�c or federal law to receive the da�a. This requiremen[s6a11 not apply when an individual is asked to supply in�esrieadve dara, pursuan[ro secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav pla-� the noace reauired under this subdivision in the individual income tax or propertv raz refund insrrucaons inscead of on chose forms. Subd. 3. ?,ccess to data bc individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stnr�data on individuals,and whe�her it is classified as public, private or confidendal. tipon his further request, an individual who is the subjecc of s[or`d privace or public dara on indi��iduals shall be shown the data wichouc any charge co him and, if he desires, shall be informed of the concenc and meaning of rhat data. After an individual has been shown the privace data and informed of ics meaning,the data need not be disclosed to him for six mor.�s�hereafrer unless a dispute or action pursuant to chis secrion is pending or addidonal data on the individual has been collected or eteated. The responsible authoriry shall provide copies of�he private or public data upon request by the individual subject of the dara. Tne responsible authoriry may rer,uire[t:e requesting penon to pay the accuai costs of makine,certifying,and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivis�on,or within five days of the dar.of the requesc,excluding Sanirdays,Sundays and legal holidays,if immedia�e compliance is noc possible. If he cannot comply with the requesc wi[hir.3iac time,he shall so inform�he individual,and may have an addicional five days wichin which to comply wirh the request,excluding Saturdays, Sunday�s and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or complzteness of public or private data cor.ceming himself. To exercise�his rieht,an individual shall noafy in writing[he responsible authoriry describing che nature of the disagreement. The responsib(e authoriry shall within 30 days eicl:er: (a)correct che data found to be inaccurate or incomplece and attemp[to nodfy past recipiena of inaccurace or incomplete data, including recipiena named by the individuai; or(b)notify tl:e individual that he believes thz data to be corcect. Data in disFute shall be disclosed only if the individual's statemen[of disagreement is included wi[h the disclosed data. The dererminarion of the responsible au�horiry may be appealed pursuanc to the provisions of the administrarive procedare act reladng to contes:�d 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 pemut or license from the City of Orono or any of i[s 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. ?. 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 a�encies to the extent necessary to process the permit or license. .�. If your requested permit or license requires Council action to approve, some information may become public. �, 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. Fint ��d�z Last Address Ciry 5tate Zip Phone I unders my '�hts tated ab ve. � � ,�� _�_._ signatur i�