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� , � Sec.13.04 RIGHTS OF SUB.TECTS OF D�TA Subd. 1. Type of data. The righcs of individual on whom[he data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given indiridual. An individual asked to supply private or confidenual data conceming himself shall be infortned of: (a)the purpose and intended use of the requested dara within the collecting'state agency,political subdivision,or sratewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supply priva[e or confidential data;and(d)[he identiry of ocher persons or enrides authorized by sta[e or federal law to receive the data. This requiremenc shall not apply when an individual is asked to supply invesrieaave data, pursuan[to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav place the norice reauired under this subdivision in the individual income tax or properev tax re_fund instruc[ions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible au[hority,an individual shall be informed whether he is the subject of scored dara on individuals, and whe�her it is classified as public, private or confidenrial. Upon his further request, an individual who is che subject of stored private or public data on individuals shall be shown che data wichout any charge ro him and, if he desires, shall be informed of the content and meaning uf�hat data. After an individual 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 acrion pursuant to this seccion is pending or addiaonal data on the individual has been collected or created. The responsible auchority shall provide copies of the private or public data upon requesc by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual coscs of making, certifying, and compiling the copies. The responsible aurhoriry 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 possibie. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addidonal 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��a[e data conceming himself. To exercise[his right,an individual shall notify in writing the responsible authority describing�he nature of the disagreement. The responsible authoriry shall wichin 30 days eichet: (a)correct the data found ro be inaccurate or incomplete and attempt to nodfy past recipienu of inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data in dispu[e shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authoriry may be appealed pursuant ro the provisions of the administrative procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�hts 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 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 pernut 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 perm.it. First Vfiddle Last Address Ciry State Zip Phone I understand my rights as stated above. � ,1.,`'`"""//�� Signature