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See.13.04 RIGHTS OF SUBJECTS OF DATA -- - Subd. 1. Type of data. The rights of individual oa wham the data is stored or to be scored shall be as sec forth in this section Subd.2. Infos oration required to be given individual. An individual eked to supply private or coafidtndal data concerning himself shall be informed of: (a)the purpose and intended use of the rcquevmd data within the collecting State agency,Nadal subdivision,or statewide systrz (b)whether h:;.ay refuse at is le required to supply-the requested data:(c)any Ierowu consequence arising from his supplying orre fusiag to supply private or cOmFdendal dam;azd(d)the identity of Otherpersoas or enrides aut4orized by state or fede_'!zw to receive the d33. This require.:enc sh.T! not apply wi:hn an i.dividual is asked to supply investigative dam,pursuant to secdoa 13.82,subdivision 5,to a law eafarcementofficer. The eerunisforer of revenue may lace the notice rauir_d under this subdivision in the individual income tax or orooery tax refund Instructions L-tstead of on those forms. Subd.3. Access to data by individual. Upon request to a respacsible authority,an individual shall be Informed whether he is the subject of stared dam on individuals.and whether it is classified as public,private or confidential. Upoa his further r_quesr an individual who is the subject of stated private or public dam on individuals shall be shown the dam without any charge to him and;if he desires,shall be informed of the content and meaning of d=data. After an individual has beta shown the private dam and informed of its meaning,the dam need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional dam on the individual has been collected or created. The responsible authority shallprovide copies of the private or public data upon request by the individual subject of the dam. The responsible authority may require the rtquesdag person to pay the acetal costs of making,certifying,and compiling the copies. The responsibte authority shall comply immediately,if possible,with any request trade 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 tierce,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and Iegal holidays. Subd.4. Procedure when data Is not accurate or complete. An individual may contest the accuracy or completeness ofpublic orprivam dam concerning Himself. To exercise this right,an individual shall notify In writing the responsible authority describing the nature of the 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 data, including recipients named by the individual;or(b)notify the individual that he believes the dam to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed dam. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to eontes..d 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 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 Ment 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. Fust Middle Last City Suite Zip Phone I understand my ricy is as stated above. Signa re