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r Sec.13.04 RIGHTS OF SLJBJECTS OF DaT.� . Subd. 1. Type of data. The rig6cc of individual on whom the data is stored or to be s[ored shall be as set focth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and inrended use of[he requesre�dar�within the collecting�tate agency,poliucal subdivision,or statewide system; (b)whether he may refuse oY is legaily required to supply the requesud data;(c)any Irnown consequence arising from his supplying or refusing to supply privace or confidential data;and(d)the idenrity of o[her persoas or enrides aufiorized by sta[e or federal law to receive the data. This requiremeat shall not apply when an individual is asked to supply invesdgadve dara,punuant to secdon 13.82,subdivision 5,to a law enforcement o�cer. The commissioner of revenue mav otace the nodce rewired under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon requesc to a responsibie authoriry,an individual shall be informed whether he is the subject of scorod data on individuals,and whecher it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown rhe 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 meaning,the data need not be disclosed to hitn for six months thereafter unless a dispute or acrion pursuanc to this section is pending or addiaonal data on the individual has been collected or crea[ed. 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 requesdng person to pay che actual cosu 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 requesc wi[hin rhat time,he shail so inform[he 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 aot accurate or complete. An individual may contest the accuracy or completeness of pubiic or private data concerning himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing fie naturo of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to n�rify past recipients of inaccurate or incomplete data, including recipients named by the 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 inciuded with the disclosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of the administradve 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 fumish certain private or confidential information. You are notified that: 1, The information you furnish will be used to detemune 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 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 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. �/j�'If Firsc Middle Last Address C��, State Zip Phone I unde d �ght stated above. Si re �