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� • � Sec.13.04 RIGHTS OF SilB.TECTS OF DaTA Subd. 1. Type of data. The ri¢h�s of individual on whom the data is s[ored or co be stored shall be as set for[h in this secdon. Subd.2. Information reqirired to be given individual_ .3n individual asked to supply private or confidential data concerning himself shall be informed of: (a) the purpose and in�ended use of the requesced data within the collec[ing"state agency, potirical subdivision,or statewide system; (b)whether he may refuse or is legally required ro supply[he requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidenrial data;and(d)the idendry of other persons or enddes authonzed by state or federal law to receive[he data. This requirement shall not apply when an individual is asked to supply invesrigaave dara, pursuant to section 13.82, subdivision�, to a law enforcement o�cer. The commissioner of re�enue mav place the norice required under this subdivision in the individual income tax or propertv tax refund instructions ins[ead of on those forms. Subd. 3. Access to data by indiridual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of scored data on individuals,and whe[her i[is classified as public, private or confidenriaL Upon his further request, an individual who is the subject of stored private or public data on individuals shall be shown the data wi[hout any charge to hirn and, if he desires, shall be informed of the content and meaning of[hat data. After an individuai has been shown the privace data and informed of its meaning,the data need not be disc(osed to him for six months thereafter unless a dispute or acrion pursuant to this secaon is pending or addiaonal data on the individual has been cotlected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subjec[of the data. The responsible authoriry may require the requesting person to pay the actual costs of makine, certifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of the date of[he request,excfuding Saturdays,Sundays and fegal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform[he individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedureµ�hen data is not accurate or complete. An individual may contest the accuracy or completeness of public or pm�ate data concerning himself. To exercise chis rieht,an individual shall notify in writing the responsible authoriry dzscribing the nature of[he disagreement. The responsibte authoriry shal(within 30 days either. (a)correct the da[a found to be inaccunte or incomplete and attempt to norify past recipients of inaccurate or incomplete data, including recipients named by the individual; or(b) notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statemen[of disagreement is included with the disclosed data. The determina[ion of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�hts 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 pemut 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 pernut or license. 4. If your requested permit or license requires Council action to approve, some information may become public. j. You have cenain ri�hts 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 permi[. i � / ��'�/C 1-- First � iddle 7 Last �� �, � . Address ��I ��w U-� �� V�� ` �� `� "� � Ciry State Zip Phone I understand my rights as stated above. � f Signa[ure