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� -�. , Sec.13.04 RIGHTS OF SUBJECTS OF DATA S�bd. 1. Type of data. The rights of individual on whom the data is stored or w be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to suppiy private or confidendal data concerning 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 requested data;(c)any lmown consequence arising from his suppiying or refusing to supply private or co�dential data;and(d)the iden.tity of other persons or entides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked w supply investigative data,pursuant W section 13.82,subdivision 5,to a law enfo.rcement officer. The commissioner of nvenue mav place the nodce rewired under this subdivision in the individual income taz or orooertv tax nfund insuuctions insuad of on those forms. . Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individnals.and whether it is classified as public,private or confidential. Upon his funher 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 that 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 thereafur unless a dispuu or action pursuant to this section is pending or addidonal data on the individual has been collected or created. The respoasible suthority s6all provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesung person to pay the actual costs of waking,certifying,and compiling the copies. The responsble authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,ezcluding 5anudays,Sundays and legal holidays,if immediate compliance is aot possible. If he cannot comply with the request wiihin that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excludirig Saturdays, - Sundays and legal holidays. Subd.4. Procedure when data ic not acenrate or complete. An individual may contest the accuracy or completeness of public or private ' data conceming himseif. To ezercise this right,an individuai shall nofify ia writing the nsponsible authority descn'bing the nawre of the disagreement. The cesponsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and amempt w nodfy 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 dispuu 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 pursuant to the provisions of the administiaCve procedun act reladng 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 furnish certain private or confidential information. ' You aze 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 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 ce�tain 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. �<<.tt L e.c_ � First Mi e Last , � Address .... � `S G�2 . ' �-/ � Ciry � State Zip P one I unders d my ri as stated above. , Signature