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Sec.13.04 RIGHTS OF SUBJECTS 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 section. Subd. 2. Information required to be given 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 system; (b) whether he may refuse or is legally required to supply the requested data; (c) am known consequence arising from his suppiying or refusing to supply private or confidential data; and (d)the identity of other persons or entities authoraed by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigati��e data,pursuant to sectioo 13.82,subdivision 5,to a law enforcement officer. ' The commissioner of revenue mav alace the notice reauired under this subdivision in the individual income tax or orooertv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a respo�ble authority, an individual shall be iniormed whether he is the subject of stored data on individuals, and whether it is classified as public, private or rnnbdential. Upon his further request, an individual who is the subject of stored private or public data on individuals shall be sho«r the data without am charge to him and, ii he desires, shall be informed of the content and meaning of that data. After an individual has been sho��n the private data and informed of its meaning, the data need not be disclosed to him for six months thereaNer unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall pro�ide copies of the private or public data upon request by the individual subject oi the data. The responsible authority may require the requesting person to pay the actual costs of maldng,certifying,and comp�7'mg the copies. The responsible authority shall comply immediatety, if possible, with aay 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 shall so inform the individual, and may ha�•e an additional five da}s within which to comply with the request, excluding Saturdays, Sundays and legal holidays. Subd. 4. Procedure when data is not accurate or complete. r1n mdividuat may contest the accuracy or completeness of public or private data concerning himself. To erercise this right, an ind'nidual shall notity in wTitmg the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a) corcect the data found to be inaccurate or incomplete and attempt to notity 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 included with the disclosed data. The determination of the responsible authority may be appealed pursaant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with �1.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 shared ��ith 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 (availab(e�pon request)to review private data on yourself. 6. Your full name is required to process this application or permit. �L;G�,a� C'�.IS�,�I First Middle Last y��( Z�n s-r. � lo� Address _��ls;� M� SS33� �52- H�N- c�i t� City State Zip Phone I understand my rights as tated above. � Signature