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- � a� 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 ttus secdon. Subd.2. Infotmation required to be given individual. An individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting srate agency,political subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requesud�ata;(c)any lmown consequence arising from his supplying or refusing to supply private or coafidential data;and(d)the identiry of o�iie'r'�ersons or entities authorized by srete or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgaave data,pursvant to secdon 13.82, subdivision 5, to a law enforcement officer. The co�m;ssioner of revernie mav�lace the ratice reauired under this subdivision in the individual income tax or oronertv tax refund instrucrions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an i�lividual shall be informed whether he is the subjcet of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or�blic data on individuals shall be shown the dara without any charge to hun 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 it�meaning,the data need not be disclosed to him for six mo�hs thereafter nnless a dispute or ac6on pursuant w this section is pe�ing or additional 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 dara. The responsible authoriry may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies. The responsible suthoriry 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 6olidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request, excluding Sariirdays,Sundays and legal holidays. S�bd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or privaoe data concemiog himself. To exercise this right,an individual shall notify in writing the responsible suthoriry describing the nature of the disagreement. The responsible suthoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt w notify past r�ipients of inaccurnte or icxomplete data,i�luding recipients named by the individual;or(b)notify the individual that he believes the data w be correct. Data in dispute shall be disclosed only if the individual's staument of disagreement is iacluded with the disclosed data. The determinauon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating W contesud 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 Gity 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 fumish 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 shared 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. ��o� First Middle Last Address Ciry State Zip Phone I understand my r' as ve. Sig e ' � 6