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. Sec.13.Od RIGHTS OF SUBJECTS OP llAT� Subd. 1. T}pe of data. The rights of individual on whom the data is stored or to be s[ored sha(I be as set forth in this section. Subd2. Information required to begiven individual. An individual asked to supply pnvate or confidential dataconceming himselfshall be info�med of. (a)the purpose and intended use ofthe requested data�viU�in the collecting state agency,political subdivisioq or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any kno�vn consequence arising from his supplying or refusing to supply private or confidential data;and(d)Che identiry of other persons or entities authorized by state or federal law to receive the data. "I�his requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner_of revenue_may�lace the notice required under this subdivision in the individual income tux or nroperty tax refund instructions instead of on those forms. Subd.3.Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classi[ied as public,private or confidential. Upon his further request,an individual who is the subject of stored private or publ ic data on individuals shall be shown the data without any charge to him and,if he desires,shal I be informed of the content and meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending 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 ofthe data. The responsible authority may require the requesting person to pay the actual costs of making certifying and compiling the co�ies. The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within 6ve days of die dale of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannotcomply with the request within that timq he shall so inform die individual,and may have an additional five days within which to comply with the request,exclud�ng Saturdays, Sundays and legal holida}�s. Subd.4. Procedure�a�hen data is not accurate or complete. An individual may contest the accuracy or completeness ofpublic or private data concerning himself. To e�ercise this right,an individual shal I notify in writing the responsible authority describing the nature of the disagreement.The responsible authority shall�aithin 30 days either. (a)correct the data found 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 data ro be correct Data in dispute shall be disclosed only if the individual's statement of disagreement is induded 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}�our request for a permit or license rrom the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notitied that: 1. The information you f'urnish 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 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. Ifyour 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 revie�v private data on yourself. 6. Your full name is required to process this application or permit. f t'"l S � fl,� � �� First Middle Last �� o .� 8 u -�" � � A��r�ss — I �� I� � / ' 1 � � S �{ oZu City State Zip Phone ♦ I understand my rights as stated ove. � 'anature �� 32 � �� �� b ��;�:�z.,��,� � ,,,<,