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r"' � Sec.13.04 RIGKIS OF SL'BJECTS OF D:�Ta Subd. 1. Type of data. 'Ihe righcs oi individual on whom the dan is srored or ro be storcd shall be as set forth in chis secdon. Subd.?. Informadon reqirired to be�vm individual. �ln individual asked to suppIy privare or confidendal dara conceraing himself shalI be informed of: (a)the purpose and inrnded use of the requested daca wi�hin the collecdag'stare agency,polidcal subdivision,or sracewide systm: (b)whelier he may rfuse or is legaily cequired ro supply rhe requesud dara:(c)any known coasequeace arising from his supplying or refusing ro supply priva[e or conf:dendal dara;and(d)[he idaaaty of ocher persons or enades au�horized by sca[:or federai law to receive the da�a. This requiremenc shall not apply when an individual is asked to supply ia��esdeadve dam, pursuanc co secdon 13.82, subdivision 5, to a law enforcemenc o�cer. "Ihe commissioner of re�enu riav pla- the nodr r�uired undec this subdivision in the individual income tax or prooem taz refur.d instrucuons instz�d of on�hose forms. Subd.3. access to data bp individual. Cipon requesc to a responsible auchoriry,an individual shall be informed whe�her he is�he subjec� of scor_d data on individuais,and wherher it is ciassified as public, priva[e or confidendal. tipon his fur�her request,an individual who is the subjecc of stor_d private or public dan on individuals shall be stiown che daa wichout any charge to him and,-if he desires, shall be iniormed of the con[enc and meaning of chat dan. After an individua!hu 6rn shown che private da[a and informed oi its meaning,the data need no�be disdosed to hun for siz monchs chereaiur unless a dispu�e or acrion pursuanc w �his secdon is pending or addidoaal da[a on the individual has been collecud or creared. The responsiblz authoriry shall provide copies of d1e privace or public data upon requesc by the individual subject of che dara. "I"ne responsible auchoriry may requir che requesring person to pay[he acnia!cose�of making.certifying,and compiling the copies. The responsibla authoriry shalI comply immediacely, if possible, wi[h any request made pursuant to this subdivision,or wi[hin five days oi the dam of che requesc,ezciuding Sacurdays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannot comply with rhe reques[ wi�hin chac[ime,he shall so inform[he individuai,and may have an addidonai five days wi�hin which to comply wi�h the request,excluding Sarurdays, 5undays and legsi holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest che accurdcy or compleceness of public or pri�•ate ' dara concerning himself. To exer:ise chis righc,an individual shall noafy in wriang che respoasible auchoriry dzscribing�he nacu;e of the disagctemeac . The responsibla auchoriry sh�ll within 30 days eicher. (a)correu�he data found�o be inaccuracz or incomplete and aaempt to nodfy past tecipienu of inaccura�e or incomple�e dac�, including recipienc�named by �he individual; or(b)aodfy �:e individual thac he believes the dan to be correcG Data in dispu�e shall be disc!osed only if che individual's statemenc of disagreemenc is ir.cluded wi[h che disclosed dara. The decerminaoon of the responsible au�horiry may be appealed pursuanc to the provisions of[hz administrarive procedure act reladng to contested cases. DAT� PRIVACY ADVISORY In accordance wich�1.5. 13.04, Subd.2, "Rights of subjecu of data", we would like to inform you tha[your request for a permit or license from che Ciry of Orono or any of ics departments may require you to fumish cercain private or confiden�ial information. You are notified that: 1, The information you furnish will be used to determine your qualification for che permit or license requested. ?. You may refuse to supply da�a, but refusai may require thac the Ciry deny the permic or license. ;. The information may be shared with ocher local, stace 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. �, You have cena.in rishcs under ;�f.S. 13.04 (available upon request) to review private data oa yourself. 6, Your full name is required to pcocess chis application or permit. Fint �fiddlz Last ?.ddcess Ciry State Zip Phant I understand my ri�hts �s staced above. . Signantro