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TY OF ORONO 1; 6124730510 09/24/96 14:00 5 :03/03•NO:5�2 3ec.13.04 RIGIITS OF SUWECTS OF DATA Subd. 1. Type of data. The rights of individual oil whom the data Is stored or to be stored shall be as set forth In this section. Subd.2. Warmation regddred to be given individual. An individual asked to supply private or confidential data concerning himself shall be Informed of: (a)die purpose and intended use of the requested data within the collecting hate agency,political subdivision,or statewide system: (b)whether 1w may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private orconfldential dam;and(d)the identity of other persons or enddes authorized by state or federal law to receive rhe data. This requirement shall not apply when an individual is asked to supply Investigadve data, pursuant to section 13.62, subdivision S. to s law enforcement officer. M cum tit sgnez of rcve true m9v glace the notice required under this subdivision in the individu}i income isx or orotum rax rekrid Iruttucdont lmswtdgf on NP-9 form4. Subd. 3. Access to data by individual. Upon request to a responsible authority,in 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 shalt 4e shown the dam without any charge to him and,'if he desires,shall be informed of the content and inkaning of dist data. After an individual has been shown the private data and informed of its meaning. the data need not be disclosed to him for drt anondts 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 auftrity shall provide copies of rhe private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,cenity{ng.and compiling the copies. 'The responsible authority shall 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. Ifte cannot comply with the request within that time,he shall 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 whin data is net accurate or complete. An individual may contest the accuracy or complerenoss of public or private dim comornbtg Himself. To exercise this right,an individual shall notify in writing the responsible authority describing die nature of the disagreement. 'rhe responsible Authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify put recipients of Insewtate or incomplete darn, Including recipients named by die individual;or(b)notify the individual that he believes the data to be correct. Data iso dispute shall be disclosed ottly if the individual's statement of disagreement is included with the disclosed dare. The determination of the responsible authority 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, "Flights 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 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. Fera Wddta I.aat �\ I.- l� Address - rn'+� sal, Iso 3 s• City Sass zip Miss r I-understand rely rights as stated above. 8ignoture