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' � 1 Sec.13.04 RIGI-iTS OF SUB.TECTS OF D�TA Subd. 1. Type of data. The rights of individual on whom[he data is stored or to be stored shall be as set forth in this secaon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal dara concerning himself shall be informed of: (a)the purpose and intended use of the requested dara within the collecting'state agency,polidcal subdivision,or statewide system; (b)whether he may refuse oT is legally required to supply the requested data;(c)any lmown consequence arising fmm his supplying or refusing to supply private or confidendal data;and(d)the idendry of o[her persons or enriaes au[horized by state or federal law to receive the data. This requiremenc s6a11 not apply when an individual is asked to suppiy investigadve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav place the norice required under this subdivision in the individual income tax or propertY tax refund instructions insread of on those forms. Subd. 3. Access to data br individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals, and whe[her it is ctassified 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 the data without any charge to him and, if he desires, shall be informed of the content and meaning of chat data. After an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to hun for six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal 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 individuai subject of the data. The responsible authoriry may require the requesting person to pay the 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,exciuding 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 have an addidonal five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall noafy in wridng the responsible authority describing�he nature of the disagreement. The responsibte authoriry shall within 30 days either: (a)correct the data found to be inaccunte or incomplete and attempt to nodfy past recipienu of inaccurate or incomplete data, including recipients named by the individual;or(b)nodfy 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 auchoriry may be appealed pursuant to the provisions of the adminis�arive 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 deternune your qualification for the pemut or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the pemut or license. 3. The information may be shared wich 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. First Middle Last Address Ciry State Zip Phone I understand my rights as stated above. �_____�_.,_� Signature