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♦ . L Sec.13.04 RIGH'TS OF SUBJECTS OF D�TA Subd. 1. Type of data. The rights of individual ou whom che data is stored or to be stored shall be as set forth in this secdon. Subd.'_. Information required to be given individual. An individual asked to supply private or confidendal data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecring"statt agency, political subdivision,or statewide system; (b)whether he may refuse or is legally required to supply[he requested data;(c)any 1�own consequence arising fmm his supplying or refusing to supply private or conridential data;and(d)the identirv of other persons or enrities authorized by state or federal law to receive the data. This requirement shali not apply when an individual is asked to supply invescieaave dara, pursuanc to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enuz mav place the nodce reauired under this subdivision in the individual income tax or properev tax tefund instructions instead of on those forms. Subd. 3. Access to data br individual. Upon request to a responsible authority,an individua!shail be informed whether he is the subjec[ of stored data on individuals, and wherher it is classified as public, private or confidenrial. Upon his further request,an individual who is che subject of stored private or public data on individuals shall be shown the data without any charge to hun and, if he desires, shall be informed of the conten[ and meaning of rhat data. After an individual has been shown che private data and informed of its meaning, the data need not be disclosed to hirn for six months thereafter unless a dispute or acrion pursuant to [his secrion is pending or addidonal data on[he individual has been collected or created. The responsib(e aurhoriry shall provide copies of the priva[e or public data upon request by rhe individual subject of the data. The responsible authoriry may require[he requesring person to pay the actual cosu of making, certifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, wieh any request made pursuant to this subdivision, or within five days of the date of the request,excluding Sacurdays,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 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 pri��ate data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing[he na[ure of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienrs 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 statement of disagreement is included with the disclosed data. "I'tie de[ermina[ion of the rasponsible authoriry may be appealed pursuant to the provisions of the administrarive 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 wich other local, state or federal a�encies to the extent necessary to process the pemut or license. 4. If your requested pernut or license requires Councii 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. (, Your full name is required to process this application or permit. First Middle Last Address City State Zip Phone I understand my rights as stated above. ��^�- ^ �f� ' Signature