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, - Sec.13.04 RIGH'TS OF SLJB.JECTS OF D�TA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be scored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal dara conceming himself shall be informed of: (a) the purpose and inrended use of the requested data within the collecting'state ageacy,poliacal subdivision,or statewide sysum; (b)whecher he may refuse or is legatly required to supply che mquesced data;(c)any lrnovm consequence arising from his supplying or refusing to supply privace or confidentiai dara;and(d)the idenriry of other persoas or enaaes authorized by sta[e or federal iaw to receive the data. This requiremenc shall not apply when an individual is asked to supply invesrigadve dara, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the noace rewired under this subdivision in the individual income tax or properrv tax refund instructions inscead of on those forms. Subd. 3. Access to data b�individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of scored data on individuais,and whe[her it is classified as public, priva�e or confidendal. Upon his further request, an individual who is the subject of stored private or public data on individuals shall be shown che dara wichout any charge to him and, if he desires, shall be informed of the content and meaning of[hat data. Afrzr an individual has been shown�he private data and informed of i�s meaning, the data need not be disclosed to him for six months thereafter unless a dispute or acrion pursuanc co this secrion is oending or addidonal data on the individual has been cotlected or creared. The responsible authoriry shali provide copies of the privace or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the actual cosu of makine, cerrifying, and compiling the copies. The responsible auchoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the date of rhe request,excluding Saturdays,Sundays and lega!holidays,if immediace compliance is not possible. If he cannot comply with the requesc within that time,he shall so inform che individual,and may have an addidonal five days within which co comply with che 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 chis righc,an individual shall nodfy in wriring�he responsibie auchoriry describing�he nacure of the disagreemeoc. The responsible authoriry shall wichin 30 days either: (a)correct che data found to be inaccurate or incomplete and attempt to norify past recipients of inaccurate or incompiete dara, including recipienrs named by che individual; or(b)notify the individual tha[he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. The determinadon of the responsibte auchoriry may be appealed punuan[to the provisions of the adminis�aave procedure act relaang to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "RiQ.hts of subjects of data", we would like to inform you that your request for a pernut or license from the City of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified thar. 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 Ciry deny the permit or license. 3. The information may be shared wi[h ocher local, state or federal a�encies to the extenc necessary to process the pemut 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 N1.S. 13.04 (available upon request) [o review private data on yourself. 6. Your full name is required to process this application or permit. Firsc �tiddle Lasc Address C�h, State Zip Phone I understand my ri;hts as stated above. � � Signature