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� � + Sec.13.04 RIGATS OF S[JBJECTS OF DATA Subd. i. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secaon. Subd.2. Informatlon req�rired to be�ven individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting State agency,political subdivision,or statewide sysum; (b)whether he may refuse oY is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refitsing to supply private or confidential data;and(d)the identiry of other persons or enfldes authorized by state or federal law to receive the data. This requirement shall not appiy when an individual is asked to supply invesdgaave dars,pursuant to secdon 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav nlace the noace required under this subdivision in the individual income tax or proaertv taz refund instrucdons insfead of on those forms. Subd.3. Access to data by iadividual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stomd data on individuals,and whe[her it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stoc�d.private or public data on individuals shall be shown the data,without any charge w 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 o`f its meaaing,the data need not be disclosed to him for six months thereafter unless a dispuu or acdon pursuant to this secrion is pending or additional data on the individual has been collected or created. The responsible authoriry shall provide Copies of the private or public data upon nquest by the individual subject of the data. The responsible authoriry may require the reqnesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible au�ority shall comply immediarely,if possible,with any request made pursuant to this subdivision,or within five days of the date of the nquest,excluding Saturdays,Sundays and legal holidays,if immediau compliance is not possible. If he cannot comply with the request wi�ic►that time,he shall so inform the individual,and may have an ad�idonal five days within which to comply w�th the request,excluding Saturdays, Sundays and legal holidays. ' � � Subd.4. Procedure when data is not accurate or complet�. An individual may contest the accuracy or completeness of public or private dara concerning himself. To exercis�this nght,an individual shall nodfy in writing the responsible authority describing the naturo of the disagreement The responsible authoriry shall within 30 days either: (a)correct the dara found ro be inaccurate ar,incomplece and attempt w nodfy past recipienu 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 included with the disclosed data. The determinaaon of the responsible authority may be appealed pursuant to the provisions of the administcadve procedure act relating co 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 City of Orono or any of its departments may require you to furnish certain private or confidential information. You ue notified that: • 1. � The i�formation 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. (, Your full name is required to process this application or permit. First Middle Last Address • Ciry State Zip Phone I understand my.rights as stated above. Signaatre