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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 conceming himself shall be inf'ormed of. (a)the pur�wse and intended use ofthe requested data within Ihe collecting state agency,political subdivisioq or statewide system;(b) whether he may refuse or is legafty required to supply the requested data;(c)any known conseque�ce arising from his supplying or refusing to supply private or confidential data;and(d)the ide�tity of other persons or entities authorized by state or federal law to receive the data.1'his requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may_place the notice required under this subdivision in the individual income tax or proper[v tas refund instructions instead of on those forms. Subd.3.Access to data by individual.Upon request to a msponsible authority,an individual shall be informed whether he is the subject 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 public data on individuals shall be shown the data without any charge to him and,if he desires,shall be infornied of the content and meaning of that data. Afier an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter 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 provide copies of ffie private or public data upon request by the individual subject of the data. The responsible auihority may raquire the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall c;omply immediately,if possible,with any request made pursuant to this subdivision,or within fivedays of the date of the request,excluding Saturdays,Sundays and Iegal hol idays,if immediate complia�e is�rot possible.If he cannot comply with the request within that time,he shafl so inform the individual,and may have an additional 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 accurac,y or compieteness of publK or pnvaFe daia conceming himself.To exercise this right,an individual shall notify in writing the responsible authority describing the�ture ofthe disagre�+!�t"Ch.P responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempE to rrotity�st rrcipierts of ma�x:u[ate or uxumptete lIBIH,un:luimg ru:rpKnu r�5 Cay the melividual;or(b)notify the individual that he believes the data to be correct.Data in dis}�ute shall bz disclosed only if tt�imiividuaPs statement of disageement is included with the disclosed data. T�e.jcten�uikttion ef tlie�es��sit>le autlx>ritV may be appealed pursuant to the provisions of the administrative 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 wnfidential 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 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. ��1�� '�-;t �/�/��1L,�=- �.� �l C'id:� �-5 First Middle Last � �� 7�� G�? /G�/�L `��( �J�l/ �}'��z Address Q � /`�J'�C� `vl/Gl��l��1 i�'i� �7%O � .�..j / ' �,r��•-�-�D>� �/ � City State Zip Phoae I under� y righ�a as stated abf ov�._.\ _ C'�. ��`---:j i � '��il�. �% �D ��--> s�nan�.� Reset Form 32 ;s .;'�;�c =.