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Sec.13.04 RIGHTS OF SUSJECTS OF DaT�, Subd. 1. Type of data. The rights of individual on whom che data is stored or to be stored shall be as set forth in this secrion. Subd.2. Information req�rired to be given individual. An individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data wichin the collecting'state agency, polidcal subdivisio�,or sratewide system; (b)whether he may refuse oT is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply privare or conndendal data;and(d)the iden[iry of ocher persons or enrities au[horized by state or federal law to receive[he data. This requiremen[shall no[apply when an individual is asked to suppty investieadve dara, pursuant ro secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav place the noace reouired under this subdivision in the individual income tax or propertv tax refund instructions instzad of on those forms. Subd. 3. Access to data by indi�zdual. Upon request to a responsible authoriry,an individual shall be informed whe[her he is the subject of stored data on individuals,and whe[her it is classified as public, private or confidenaal. Upon his further request, an individual who is[he subject of stored private or public data on individuals shall be shown[he data wi[hout any charge to him and, if he desires, shall be informed of the content and meaning uf chat data. Afrer an individual has been shown che private data and informed of ics meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acrion pursuant to this secaon is pending or additional data on the individual has been collected or crea[ed. The responsible auchoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual cosu of making, certifying, and compiling the copies. The responsib(e authoriry 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 leeal 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 an addidonal five days within which to comply with the request,exciuding Sarurdays, 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[his rieht,an individual shall noafy in wriring the responsible authoriry dzscribing�he narure of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempe to norify past recipients of inaccurate or incomplete data, including recipients named by [he individual; or(b)notify the individual that he believes the data to be correc[. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. Tlie decermina[ion of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relacing to contesced 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 permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the pemut or license. 3, The information may be shared with other local, state or federal agencies to the extent necessary to process the pemut or license. 4. If your requested permit or license requires Council action to approve, some information may become public. j. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. 6, Your fuil name is required to process this appiication or permit. �o�� N� , (�,i�`�- First � Middle,�=T,�� Last � l 1 � � � �� Y � Addr�'��\�/ r� �1" �� —�� C�ty ' State Zip Phone erst d my ri hts sta d bo e. Signa e