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Sec.13.04 RIGHTS OF SLIB.TECTS OF DATA Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forrh in this secdon. Subd.2. Information required 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 requesced dara within the collecang'state agency, poliacal subdivision,or statewide system; (b)whether he may refuse or is legally required to supply the iequested data;(c)any l�own consequence arising from his supplying or refusing to suppty privare or confidenrial data;and(d)the idendry of other persons or entiries auchorized by state or federal(aw to receive the data. This requirement shall not apply when an individual is asked to supply invesdgaave dara, pursuant to secrion 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of revenue mav place the nodce required under this subdivision in the individual income tax or propertv tax refund instrucrions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public, priva[e or confidential. Upon his further request, an 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 desires, shall be informed of the content and meaning of that data. After aa 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 seccion is pending or addidonal data on the individual has been coflected or created. The responsible au[horiry shall provide copies of the private or public data upon request by the individual subject of[he data. The responsible auchoriry may require the requesting person to pay the actual costs of making, certifying, and compiling the copies. The responsible authoriry shall compty immediately, if possible, with any request made pursuanc to this subdivision, or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is no[possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays, Sundays and legal ho(idays. Subd.4. Procedure when data is not accurate or complete. An individual may con[est the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry dzscribing the nature of the disagreemen[. The responsible authoriry shafl within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by [he individual; or(b) notify the individual that he belizves 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. The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the administracive procedure act relating to concested 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 permit or license from the City of Orono or any of its departments may require you to fumish cer[ain private or confidential information. You are notified that: 1. The information you furnish will be used to detemune 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 a�encies to the extent necessary to process the permit or license. 4. If your requested pernut 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 review private data on yourself. 6. Your full name is required to process this application or permit. First �tiddle Last Address City State Zip Phone I understand my rights as stated above. Signature