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� Sec.13.04 RIGH'TS OF SLIBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom che data is stored or to be stored shall be as set forth 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 intended use of the mquested dara within the collecting'state agency,polidcal subdivision,or statewide system; (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 confidenaa!data;and(d)the identiry of ocher penons or enri[ies au[horized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrieadve dara,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual inco.ne tax or propertY tax refund instructions instexd of on those forms. Subd. 3. Access to data by individuai. Upon request to a responsible authoriry,an individual shall be informed whe[her he is the subject of stored data on individuals,and whecher it is classified as public, priva[e or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data wichout any charge to hun and, if he desires, shall be informed of the content and meaning of�hat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acrion pursuant to this secaon is pending or addidonal data on the individual 6as been collected or created. The r�sponsible authoriry shall provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authority may require the requesring person to pay the actual cosu of making,cerafying, and compiling the copies. The responsible authority 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 compiiance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,exciuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness bf public or private data conceming himself. To exercise[his right,an individual shall notify in writing che responsible authoriry describing[he nature of the disagreement. The responsible authoriry shali within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by the individual;or(b)no[ify 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 with the disclosed data. The determinarion of the responsible authoriry may be appealed pursuant to the provisions of the administrative 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 pernut 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 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 shared with other local, state or federal agencies to the extent necessary to process the pernut 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 State Zip Phone I unde y rights as stated above. .. g � �� Sign ture