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� � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is scored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given individual. An individual asked to supply private or co�dendal data concerning himself shall be informed of: (a)the purpose and incended use of the rEquesced data within the collecting'state agency, poliacal subdivision, or stacewide system; (b)whether he may refuse or 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 idenary of other persons or enades authorized by state or federal law[o receive the data. This requirement shall not appty whe�an individual is asked to supply investigaave data, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propercv tax 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 whe[her he is the subject of stored data on individuals,and whether it is classified as public, private or co�den[ial. Upon his further request, an individual who is the subject of stored private or public data on individuals shall be shown the data wi�hout any charge to hicn and,'if he desires, shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,tbe data need not be disclosed to him for six months thereafter unless a dispure or action pursuant to this secdon is pending or additional data on the individual has been collected or created. The responsible authority shali provide copies of the private or pubiic data upon requesc by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costs of making, cemfying, and compiling the copies. The responsibie au[horiry 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 hofidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so infornt the individual,and may have an addidonal 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 contesc the accuracy or completeness of public or pmate data concerning himself. To exercise this right,an individual shall notify in writing ttie responsible authoriry describing the nature of the disagreemen[. The responsible authoriry shall within 30 days either. (a)correcc the data found to be inaccurate or incomplete and attempt to nodfy past recipiencs of inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individuai that he believes the data to be correct. Data in dispute shail be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determina[ion of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating 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 information. You are notified that: 1. The information you fumish will be used to determine your qualification for the pemut or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the pernut>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. �'�r-Gl,�.�� '/� �1� First , �fiddle Lasc Address /, � 7 / �� Ciry State Zip Phone I understand my rights as stated a ve � � Signature