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Sec.13.04 RIGHTS OF SLJBJECTS OF D�TA Subd. !. Type of data. The rights of individual on whom the data is stored or to be scored shall be as set forth in this secaon. Subd.2. Information reqirired to be given individual. ,�n individual asked to supply priva[e or confidendal data conceming himself shall be informed of: (a)the purpose and in[ended use of the requesud data wi[hin the collecdng'stare agency, poliacal subdivision,or statewide rystem; (b)whecher he may refuse ot is legally required to supply the requested data;(c)any 1�own coasequence arising from his supplying or refusing to supply priva[e or confidentia!data;and(d)the idendry of other persoas or enades authorized by state or federnl law to receive the data. This requircmenc shall not apply when an individual is asked to supply invesdgadve dara,pursuant to secdon 13.82, subdivision 5, [o a law enforcement officer. The commissioner of revenue mav place the nodce rewired under this subdivision in the individual income rax or propem tax refund instructions inscead of on those forms. Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subjecc of stored data on individuals,and whe[her it is classified as public,priva�e or confidendal. Upon his further request, aa individual who is the subject of stored private or public data on individuals shall be shown the data wi[hout any charge to him and, if he des'ues, shall be informed of the content and meaning of�hat data. After an individual has been shown the private data and informed of i�s meaning,the dara need not be disclosed to hicn for six mon[hs thereaher unless a dispute or acdon pursuanc to chis secrion is pending or addiaonal data on the individual 6as been collected or creaced. 'Ihe responsible authoriry shall provide copies of the private or public data upon request by the individual subject of che dara. The responsible authoriry may require rhe requesdng person to pay the actual cost�of makine,cervfying,and compiling the copies. The responsible authoriry shall comply immediately, if possible, wi[h any request made punuant to this subdivision,or wichin five days of the date of[he request,excluding Saturdays,5undays and legal holidays,if immediate compliance is not possible. If he cannot compty with the requesc within thac dme,hz shall so inform[he individual,and may have an addiaonal five days within which to comply with[he 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 this right,an individual shall noafy in writing che rosponsible auchoriry describing the nacure of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempc to noafy past recipients of inaccurace or incomplece data, including recipiencs named by[he individual;or(b)nodfy the individual thac he believes the data to be correct. Data in dispuce shall be disclosed only if[he individual's stacement of disagreemenc is included with the disclosed data. The determinadon of the responsible auchoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to contesced 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 request for a pemut or license from the City of Orono or any of its departments may require you to fumish 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 tha[ the City deny the peruut 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 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 permit. ��`eJ'C'� ��V{/, �C�L Q�C First Last �� i e /1 Address � �� Li57 �J��// �/�ic 0 � � �� Ciry State Zip Phone I understand my ri�h as state ab e. Signan.tre