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Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individuAl on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information reyuired to be given individual. An individual asked to supply private or confidentia]data concerning himself shall be infonned of: (a)the purpose and intended use of the requested ciata within the collecting state agency,political sulxiivision,or statewide system;(b) whether he may reYuse or is legally required to supply the reyuested data;(c)any I:nown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other Fx;rsons or entities authorized by state or federal law to receive ihe data. 7�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.place the notice required under this subdivision in the individual income tax or property tax refund instructions instead of on those forn�s. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infortned whether he is the suUject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an indicidual who is the subject of stored private or public data on lndividuals shall be shown the data without any charge to hun and,if he desires,shall be infoirried of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this sectian is pending or additional data on the individual has been collected or created. The responsible authonty shall provide copies of the pnvate or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority 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 legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individuai,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Sulxi.4. Procedure when ciata is not accwate or complete. An individual may coutest the accuracy or completeness of public or private data conceming himselE To exercise this right,an individual shall notify in writing the responsible authority describing the natwe of the disagreement. The responsible authonty shall within 30 days either: (a)coirect the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the inciividual;or(b)notiiy the individual that he believes the data to t�e correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed ciata. 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 subj ects 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 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 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. 6. Your full name is required to process this application or permit. First Midd � Last � � re.� Address � �o . � �_ � l..J� City State Zip Phone �/ J �� �✓ I understan y rights as st ed above. � � Signature "�, ��,