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i r Sec.13.04 RIGHTS OF SLJBJECTS OF DATA . Subd. 1. Type of data. The righcs af individual on whom the data is stored or w be stored shall be as set forth ia this section. Subd.2. Information req�rired 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 data within the collecting Tstate agency,political subdivision,or statewide system; (b)whether he may refuse oY is tegally required to supply the requested data;(c)any I�own consequence azising from his supplying or refusing to supply private or confidenaal data;and(d)the idenriry of other penons or eafldes authorized by state or fedecal law to receive the data. This requiremenc shall not apply when an individual is asked to suppiy invesrigarive data,pursuant ro secaon 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or pronertv taz refund instrucdons instead of on those forms. , Subd.3. Access to data by iadividual. Upon request[o a responsible authoriry,an individual shall be informed whether he is the subject of swred data on individuals,and whether it is classi£ed as pubiic,private or confidential. Upon his further request,an individual who is the subjecc of stored private or public data on individuals shall be shown the data wichout any charge to him and;if he desires,shall be informed of the content and meaning of that data. Afrer an individual has been shown rhe private data and informed of irs meaning,the data need not be disclosed to him for siz monthc diereafter unless a dispute or acaon pursuan[to this secdon is pending or addidonal 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 iadividual subject of the data. The responsible aurhoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible aurhoriry shall compiy immediately,if possible,with any request made pursuant w 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 diat time,he shall so inform the individual,and may have an addiaonal five days witt►in wluch 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 conceming himself. To exercise chis right,an individual shall norify in wriang the responsible authoriry describing rhe nature of the disagreement. The responsible authority shall within 30 days either: (a)correcc the data found m be inaccurate or incomplete and attempt to nodfy past recipienu of inaccurate or incomplete data, iacluding recipients named by the individual;or(b)nodfy the individual that he believes the dam to be correct Data in dispute shall be disclosed oniy if the individual's statement of disagreement is included with the disclosed data. The decerminarion of the responsible authority may be appealed pursuant w the provisions of the administradve procedure act reladng 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 reauest 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 fumish 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 Ciry 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. -e r t' � �'� V\ gi�� Middle 1-�� Address Ciry Smte Zip Phone I understand my righ�as stated above. � ` . ignatt�r . �`