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Sec.13.04 RIGHTS OF SLBJECTS OF DaT� Subd. 1. Type of data. The righ�s of individual on whom[he data is stored or to be stored shall be as set fonh in this secaon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and ia[ended use of the requesced data wirhin the collecting'state agency, poliacal subdivision,or statewide system; (b)whe[her he may refuse oY is legally required to supply the mques[ed data;(c)any known consequence arising from his supplying or refusing to supply privace or confidendal data;and(d)the identity of other persons or enrioes au[horized by state or federal law to receive[he data. This requiremeot shall not apply when an individual is asked to supply invesd2adve dara, pursuant to secdon 13.82, subdivision 5, ro a law enforcement officer. The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or propercv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals, and whetl�er it is classified as public, private or confidenaal. Upon his further request, an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to hirn 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, the data need not be disclosed to him for six months thereafter unless a dispute or acaon pursuant to this secrion is pending or addidonal data on the individuai has been collected or created. The responsibie authoriry shali provide copies of the private or public data upon reques[by the individual subject of rhe data. The responsible authoriry may require the requesting person to pay the actual costs of makin¢,certiCying; and compiling the copies. The responsible authoriry 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 infornt[he individual,and may have an addiaonal 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 concerning himself. To exercise this right,an individual shall nodfy in wridng the responsible authority describing rhe na[ure of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to nndfy 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 dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the rzsponsible au[hority may be appealed pursuant[o the provisions of the administradve 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 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 pemut 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. j, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. (, Your full name is required to process this application or permit. First Vfiddle Last Address C�� State Zip Phone I understand m�Iid �ts as stat j; ove. i . �`- � f'"_" Signature