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Sec.13.04 RIGHTS OF SLlBJECTS OF D:�Ta Subd. 1. Type of data. The rights of individual on whom che data is stored or to be stored shall be as set forth in this secaon. Subd.�. Information reqtrired to be given individual. An individual asked to supply privare or confidendal dara concerning himself shall be informed of: (a)[he purpose and in[ended use of[he requesred data within the collecdng'state agency,polidcal subdivision,or statewide system; (b)whether he may refuse or is legally required to supply the requested data;(c)any irnown consequence arising from his supplying or refusing to supply private or confidenrial data;and(d)the idenriry of ocher persons or endoes authorized by state or federal law to receive the data. This requirement shall not appiy when an individual is asked to supply invesrigadve dara, punuant[o secaon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re��enue mav place the noace rewired under this subdivision in the individual income tax or propem tax refund instruccions inscead of on chose forms. Subd. 3. Access to data by individual. Upon request to a responsible auchoriry,an individual shall be informed whether he is the subject of stored data on individuals, and whether ic is c(ass�ed as public,priva[e or confidendal. Upon his further request, an individual who is the subject of stored private or public data on individuals shall be shown[he data without any charge to him and,�if he desires, shall be informed of the content and meaning of rhat data. Aftzr an individual has been shown the priva[e data and informed of ics meaning,the dara need not be disclosed to hicn for six mon[hs thereafter unless a dispute or action punuan[to [his secdon is oznding or addidonal data on the individual has been collected or cteaced. The responsible authoriry shaii provide copies of the private or public data upon requesc by the individual subject of che data. The responsible authority may require the requesring person to pay the actual costs of makin¢,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 dat�of the requesc,excluding Saturdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot comply with the request within rhat time,he shall so inform the individual,and may have an addiaonal five days wirhin 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 complereness of public or private data concerning himself. To exercise this right,an individual shall noafy in wriring the responsible authoriry describing the nature of the disagreement. T'he responsibie authoriry shall wichin 30 days ei�her: (a)correct ehe dara found to be inaccurate or incomplete and attempc to norify past recipienu of inaccunte or incompiete data, ineiuding recipients named by ehe individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispu[e shall be disclosed only if the individual's statemenc of disagreemenc is included with the disclosed data. The decerminanon of the nsponsible aurhoriry may be appealed pursuant to the provisions of the adminisaarive procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�ts of subjects of data", we would like to inform you that your reques[ for a pernut or license from the Ciry of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified thar. 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, buc refusal may require that the City deny the permit or license. 3. Ihe information may be shared with other local, state or federal a�encies to the extent necessary to process the pernut or license. 4. If your requested permit or license requires Council action to approve, some information may become public. j. You have certain rights under N1.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 Middle Last Address Ciry State Zip Phone I underst d my ri;hts as stated above. �t Signature