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Jul-18-2001 11:49am From-CITY OF ORONO +9522494616 1-436 P.002/002 F-970 Scc.I3.04 RIGHTS OF SUBJECTS OF DAT.1, Subd. 1. Type of dam. The rights of individual on whom the data is stare 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 concerning himself shall be informed of: (a)the purpose and intended use of the requested dam wi'a.in the Collecting elite agency,political subdivision,or statewide system; (b)whether he may refuse or is legally required to supply the requested dear(c)any!mown consequence arising from his supplying or refusing to supply private or confidential data:and(d)the identity of otherpersons or guides authorized by state or federal law to receive the data..This requirement shall not apply when art individual is asked to supply investigative data,pursu_.t to section 13.82,subdivision S, to alaw enforcement officer. The commissioner of revenue may place the notice required cider this subdivision in the individual income tax or proper v Rx refund kaperions instead of on rhoSe forms. • Subd.3. Access to data by individual. Upon request to a resp easible auhority,an individual shall be informed whether he is the subject of scored data on individuals,and whether it is classified as public,privam or conhdeadal. Upon his further request.an individual who is the subject of scored 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 thereafter unless a dispute or action pursuant to this section is;ending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person ro pay the actual costs of making,ce ztying.and compiling the copies. The responsible authority shall comply immediately.if possible,with may 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. If he cannot comply with the request within that time,he shall so inform the individual,and may have art addido=l 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 accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify is writing Mt responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the dam fcund 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 shalt 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 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 furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to de:ermine 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. Firs; Middle Last Address City Sate Zip Phone I understand my rights as stated above. Signature