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� � ' . Sec.13A4 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type oY data. The rights of individual on evhom the data is stored or to l�e stored shall�ie as set foith in this section. Subd_2. Infonnation requu�ed Co be given individual. An individual askecl to supply private orconiiclential data concerning himself shnll be infonned of: (a)the purpose and intended use of the requested data within thc collectino state agency,political subdivision,or statewide system;(b) whcther he may refuse or is legally required to supply tlie requested data;(c)any kno�wi consequencc;arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entilies authorized by state or federal law to receive the data. 111is reyuirement shall not apply when an individual is asked to supply invesligative data,pursuant to section 13.82,subdivision 5,to a l:�w enforcemcnl oCficcr. The commissioner of revenue mav nlace the nolice reyuired uncler tliis suFidivision in the incliv_iilual inconre tar q��rc�ert�ax refuncl instructions instead of on those fonns. Subd.3. Access to data by individuaL Upon requesf to a responsible aulhority,an indivirlual shall be infonncd whether he is the subject oP stored dala on individuals,and whether it is classitied as public,private or contidentiaL Upon t�is furdler request,an individual who is the subject of slored private or public data on individuals shall be shown tl�e d�ta wi[hout any ctiarge to him and,it�he desires,shall be inlormed of tl�e content and meaning of that data. After an individual has been shown the private data and infonned of iCs meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuaiit to this section is pendin�d or adciitional data on tlie individual has been collccted or created. Tlie responsiUle authority shail providc copies of the private or public data upon request by the individual subject of the data. The responsible authority may require Qie requesting person to pay the actual costs of making,certitying,and compiling the copies. The responsible authority shall compiy immediately,if possible,with any request ntade pursuant to this subdivision,or within five days of the date oi'the request,excluding SaWrdays,Sundays and legal holidays,if immediate compIiance is not possible. If he cannot comply wi�h the reyucst wilhin that time,he shalf so infonn lhc individual,and may l�ave an addi[ional tive days within which tu cocnply with the requesf,excluding Saturdays, Sundays and lega]holidays. Subd.4. Procedure when data is not accurate or cotnplete. An individual may conte,t the accuracy or complet�ness of public or priva(e data conccrning himselE To exercise this right,an individual shall notify in writing the tesponsibie autha ily descriUinc the nature aFthe disagreement. The responsible authority shall within 30 days either. (a)conect the data found to be inacrurate or incomplcke aod attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notity Yhe inci.ividual that he believes the data to be con�ect. Data in dispute shall bc disclosed only if the individual's stalemcnt of disa�eement is induded with the disclosed datzt. The detennination of the responsible authority may be appealed pursuanC to the provisioos of lhe administrative procedure act relalin<o to contesled cases. DATA PRIVACY ADVISOIi�' Jn accordance with M.S. 13.04,Subd.2,"Rights of subjects o f data",we would like to inforni you ttiat youi•request for a pennit ar license from the City of Orono or any of its depart�nents may require you to fuixusl�ce�rtain private or conftdeiitial information. You are notified that: L The infonnation you fiiniish will be used to detennine yo��z� qualification for the permit or liceiise requested. 2. You may refuse to supply data,but refusal may require that tlie City deny the permit or license. 3. The infoin�ation. may be shared �vith other local, state or f�dera] a�?encies to tlle extent necessary to process the pennit ar license. 4. If your requested permit or license requu�es Council action to approve, some infonnation may become public. 5. You have certain rights under M.S. 13.04 (available upr�n request)to revie�v private data oi�i yourself. 6. our full name is�required to process this application qr peinzit. f � �� Eirst " Nliddlc l�ast ^ �.. ,. ��. � � s� �ddr ' ,-,�� 7'��'�`� � �ity ' Statc 26p,-- 3'hon: �' ��—�� ��mderstand my rigl�ts as stated above. %' � �� ---_---_ _ � Si;nahu•c — -- --- f ,. ;7 �� _