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TY OF ORONO 6124730510 09/24/96 14:00 01 :03/03 NO:522- Sac.13,04 RIGHTS OF SUWECTS OF DAT a Subd. 1. Type of data. The rights of individual on Whom the data Is stored or to be storm shall be at set forth In this secdan. Subd,2. hdarmatloe rerlWad to be given individuat. An Individual asked to supply private or confidential data concerning himself xhall be informed of; (a)the purpose and intended use of the rnT=md data within the collecting lttate agency,polidW subdivisian,or statewide system: (b)whether he may refuse or is legally required to supply the requested data.(c)any known consequence arising from his supplying or refusing to supply private orconfldentlal data;and(d)the identity of other persons or euddes authorized by sate or federal taw to receive the data. This rcqulremmt shall not apply when an Individual Is asked to supply InvesdWve data,pursuant to stedoa 13.82, subdivision 5.to a Isco enforcement officer. M carne) signer of rove sue rn9v glace the notice required under this subdivW.Qn in the individual income rase or orouem taxagmrid iunglont idstalart of on tlwso forml. Subd, 3. Access to data by individual. Upon request to a responsible authority,an Individual shall be informed whether he is the suhject of stored data on individuals,and whether it is classifted as public, private or confidential. Upon his further request,an individual who is the subject of stored private or pubUc data on individuals shill be shown the data without any charge to him and,'if he desires,shall be informed of the content and nttaning of that dace. After an individual hu been shown the private dam and Informed of its meaning,the data need not be disclosed to him for six moedts thereafter unless a dispute or action pursuant m this section is pending or additional darn on the individual has been collected or created. The responsible auftrity shall provide copies of the private or public data upon request by the individual subject of the data. The msponsrbte authority may require duo requesting person to pay the=teal costs of maicing,certifying,and compiling ria copies. The responsible authority shalt comply immediately, if possible,with any 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. Ifthe catmot comply with the request within that time,ho shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays. Sundays end legal holidays. Subd.4. Procedure whka dots is not accurate or complete. An individual may contest rhe accuracy or completeness of public or private data concerning himself. To exercise this right,an indi4idual shall notify in writing du responsible authority desetibing due nature of deo disagreement. The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or Incomplete dam, Including recipients named by die Individual:or(b)notify the individual that he believes the data to be correct- Dant in dispute shall be disclosed anly 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 administrative procedure act relating to contested cases. DATA MA!QY APVY¢ORY In accordance with M.S. 13.04,Subd.2, "Flights of subjects of Bata", 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 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. 61 Your full name is required to process this application or permit. First- LUL City Sam Zip P —p n)Ll �^ 1-understarA my rights as stat above. [A Vk Blgnatu