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� • Sec.13.04 RIGHTS OF SUSJECTS OF D,�TA 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 section. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenaal data concerning himself shall be informed of: (a)the purpose and intended use of the requesred dara within the collecdng'stace agency,polirical subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply che requested data;(c)any lmown consequence arising fmm his supplying or refusing to supply private or confidential data;and(d)the idenaty of other persons or enrides au[horized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigaave dara, pursuant to secdon 13.82,subdivision 5, to a law enforcement o�cer. The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or propertv taz refund instructions inscead of on those forms. Subd. 3. Access to data by individual. Upon reques[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,private or confidenual. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data wichout any charge to him and,'if he desires,shall be informed of the content and meaning of chat data. Afrzr an individua!has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafrer unless a dispute or action pursuanc to chis secdon is pending or addidonal data on the individual has been collected or creaced. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the accual coscs of making,certifying, and compiling the copies. The responsible authority 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 ticne,he shall so inform the individual,and may have an addiriona!five days within which to comply with the request,exciuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate data conceming himself. To exercise this right,an individual shall nodfy in wridng the responsible authoriry describing[he nature of the disagreemeat. The responsible authority shall 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, inciuding recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. The determinarion of the responsible authoriry may be appealed pursuant to the provisions of the adminiscracive procedure act reladng to contested 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 Ciry of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified that: 1. The information you furnish will 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 pemut 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. 5. You have certain ri�hts 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. Fitst Middle Lasc Address Ciry State Zip Phone I understand 'b ts as stated above. Signature