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.. , - Sea13.04 RIGHTS OF S[JB.TECTS OF DATA Subd. 1. Type oE'data. The righ[s of individual on whom the data is stored or to be stored shall be as set for[h in this section. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenaal data conceming himself shall be informed of: (a)che purpose and intended use of the requesred dara within the collecang 3tate agency,polirical subdivision,or statewide system; (b)whether he may refuse o'r is legally required to supp(y the requesud dara;(c)any laiown consequence arising from his suppiying or refusing to supply priva[e or confidendal dara;and(d)the idenary of ocher persons or enrides auchorized by stace or federal law to receive the data. This requirement s6aii not apply when an individual is asked to supply invesrigarive dara,punuanc to secdon 13.82, subdivision 5, to a law enforcemenc o�cer. The commissioner of re�enue mav place the norice rewired under this subdivision in the individual income tax or propertv taz refund instcuctions ins[ead 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 ic is classified as pubiic,private or confidendal. Upon lus further requesc,an individual who is the subject of stored private or pubiic dara on individuals shall be shown rhe dan wichout any charge to him and,'if he desires,shall be informed of the content and meaning of chat data. After an individual has been shown the private data and informed of its meaning,the dara need not be disclosed to him for six mon�s thereafter unless a dispute or acaon pursuant 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 individual subject of the dan. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shalt 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 within that time,he shatl so inform the individual,and may have an additional five days within which to compiy 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 nodfy in wridng the rosponsible authoriry describing�tte nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found ro be inaccurate or incompiete and attempt to nodfy past recipienu of inaccurate or incomplete data, including recipients named by che individual;or(b)nodfy the individual thac he believes rhe data to be correcc. Dara in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. The decerminadon of the responsible authority may be appealed pursuant to the provisions of the administrarive procedure act relating 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 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. First Middle Last Address Ciry Stace Zip Phone I understand my rights as stated above. Signa[ure