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� f � Sec.13.04 RIGHTS OF SLJB.TECTS OF DATA Subd. 1. Type of data. The righcs of individual oo whom che dan is stored or to be stomd shall be as set fonh in this secdon. Subd.2. Information reqirired to be givea individual. An individual asked to supply private or confidenrial data conceming himxlf shall be informed of: (a)the purpose and intended use of the requested data within the collecting'statE agency,polidcai subdivision,or starewidc sysaem; (b)whether he may refuse or is legally mquired to supply the rcquested dara;(c)any known consequeace arising from his supplying or refusing to supply priva�e or confidenrial data;and(d)che idenciry of other persoas or entides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgaave dan,pursuant to secrion 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of revenue mav vtace the norice required urder this subdivision in the individual income tax or orooem taz 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 whethec he is the subject of stored dara on individuals, and whe�her it is classified as public, private or co�denrial. Upon his further request, an individua!who is the subject of stored private or public data on individuals shall be shown the data without any charge to hicn and, if he desires, shall be informed of the content and meaning of that data. After an individuai 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 actien pursuant ro this secdon is pending or addidoc,al dara on;he indiviuuai nas beeu cotiected or creatad. The responsible authotity shall provide copies of the privace or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the actual costs of making, certifying, and compiling the copies. The responsible au[horiry shall comply immedia[efy, 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 wi�h the request within that time,he shall so infocm the individual,and may have an addiaonal five days within which to comply wi[h the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accucacy or completeness of pubiic or private data concerning himself. To exercise[his right,an individual shall notify in writing the responsible au[horiry describing the nature of the disagreemenc. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienrs of inaccurate or incomplere data, including recipienu named by the individuaf; or(b)notify the individual that he believes the data[o be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administra[ive procedure act relacing 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 furnish certain private or confidential iniormation. You are notified that: 1. The information you furnish wiil 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 Council action to approve, some information may become public. j. You have cerain rights under M.S. 13.04 (available upon request) to review private data on yourself. (. Your full name is required to process this application or permit. � � �/' �C� C �tiddl � Last Fi� ( u � Addres � ^ � / � 4 ( C�n, = State Zip Phone I unde and my g ts as stat d above. "-�- Signa[ure