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Sec.13.04 RIGHTS OF SUBJECfS OF DATA Subd. 1. Type of data. The righb of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individuaL An individua]asked to supply private or contidential data concerning himself shall be informed of. (a)the purpose and intended use ofthe raquested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal taw to receive the data.lhis requirement sha(1 not appiy when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may olace the notice required under this subdivision in the individual income ta�c or�ropertv tax 2fund instructions instead of on those fomu. Subd.3.Access fo data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuaJs,and whether it is classified as publ ic,privaie or confidential. Upon his further request,an individual who is the subject of stored private or pubtic data on individuals shail be shown the data witiiout any charge to him and,if he desires,shalt be informed of the content and meaning ofthat dala. After an individual has bcen shown the private da[a and inform�i of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acdon pursuant to this section is pending or additionai data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the�questing person to pay the actual costs of making certifying,and compiling the copies. The responsihte authority shall comply irmnediateiy,ifpossible,with arry request macte pursuantto this subdivision,orwithin fiveday�of the date of the request,excluding Saturdays,Sundays and legal hoiidays,if immediate compliance is not possible. [f he cannot comply with the request within that time,he shall so infoem the individual,and may have an additional 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 contest the accuracy or completeness of public or private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)ttotify the individual that he believes the data to be correct.Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The detertnination of the responsib(e authority may be appealed pursuant to the provisions of the administrative prceedure act relating 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 City of Orono or any of its departments may require you to furnish certain private or co�fidential 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 permit or license. 3. The information may be shared with other 1oca1, state ar federal agencies to the etctent necessary ta 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' requir to process this application or permit. c��v�. �. �a.►�� First �a ,� ^ Middle � Last W � �5�.� �(i al h w r� ►�. Address L�--X 1 v�al�� ! � �� City State Zip Phone I understand rights as stated a e. � _ Signature Reset Form 32