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� � � Sec.13.04 RIGHTS OF SiJB.TECTS 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 secaon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data conceming himself shall be informed of: (a)the purpose aod intended use of the requested data within the collecting'state agency,polidcal subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidenrial data;and(d)the identity of other persons or endries authorized by state or federal law ro receive the data. This requirement shall not apply when an individual is asked to supply invesrieauve data, pursuant to section 13.82,subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the nocice reauired under this subdivision in the individual income tax or propertv tax refund instructions inscead of on chose forms. Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whecher it is classified as public, private or confidenaal. Upon his further request,an individual who is the subjecc of stored private or public data on individuals shall be shown the data wichout any charge to hirn and,�if he desires, shall be informed of the content and meaning of that data. Afrer an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hicn for six months thereafter unless a dispute or acrion pursuanc to this secrion is pending or addidonal data on the individual has been collected or creaced. The responsible authoriry shall provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual cosu of making, certifying, and compiling the copies. The responsible authoriry 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 individual,and may have an addirional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compleceness of public or private data conceming himself. To exercise this right,an individual shall noafy in wridng the responsible authoriry describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of inaccurate or incomplete data, including recipienu named by the individual; or(b)noafy the individual that he believes the data to be correct. Data in dispute shall be disciosed only if the individual's statement of disagreement is included with the disclosed data. The de[ermination of the responsible auchority may be appealed pursuant to the provisions of the administrarive procedure act relaang to conrested 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 furnish certain private or confidential information. You are notified that: 1, The information you furnish will be used to deternune 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 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 review private data on yourself. 6, Your full name is required to process this application or permit. /`1 f' (// U /1/�''�l � 1 ��c r/-( t-' [� First / Middie Last � 7 `/ / �Y �G7G� S)� � Address � � r�'-� " � �� / l'/` /.(�i 7 Gi / � � �l /LL v� J � �- �r _ �� .� Ciry "---- State Zip Phone I understand my rights as ted above. ; G% Signacure