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� Sec.13.0� RIGHTSOFSUBJECTSOFDATA r' Subdivision I. Type ojdata. The rights of individual on whem 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 indrvrdual asked to supply private or confidential data concerning himself shal!be informed of.• (a)the purpose and intended use of the requested data withrn the collectrng state agency,political subdivrsion,or state�vide system;(b)whether he may refuse or is legafly required lo supply the requested data;(c)any known consequence arising from his supplying or refusing to supplyprivate or confrdentral data;and(d)the identrty of otherpersons or entities authorized by state orjedera!law to recerve the data. This requirement shall not apply}vhen an individual is asked to supply rnvestigative data,pursuant to sectron 13.81, subdivisron 5, to a Imv enforcement o�cer. The commissioner o(revenue may place the notice reqt�ired under this subdivision in the indivrdual rncome tax or property tax ref�nd instructions instead of on those forms. Su6d.3. Access to data by individual. Upon request to a responsrble authority,an indivrdual shall be informed whether he is the subject of stored datn on indivrduals, and whether it is classified as public,private or confidentia[. Upon hrs further request,an individual who is the subject of stored private or public data on individuals shal!be sholvn 1he data tvithout any charge to him and, rf he desires,shall be injormed of the content and meaning of that data. Ajter an rndividual has been shotivn the private data and injormed of its meaning, the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant fo thrs section is pending or additional data on the indivrdteal has been collected or created. The responsible authoriry shal!provide copies ojthe private or public data upon reqi�est by the individual subject oj the data. The responsible authority may require the reguesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authoriry shall comply rmmedrately,ifpossrble,wilh any request made pursuant to thrs s:�bdivision,or within five days oJthe date of the reqt�est,excl:�ding Saturdays,Sundays and(egal holidays,if immedrate compliance is not possible. /jhe cannot comply with the reqtrest within lhal time,he shall so injorm the individual,and may have an additionalfive days ivithin ivhich to comply ivith the reqzrest,excluding Saturdays,Sundays and legal holidays. Subd.4. Pracedure when data is not accurate or complete.An individual may contest the accuracy or completeness ofpublic or private data concerning himse f To e.rercrse this right, an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authorrty sha!!tivithin 30 days eilher: (a)correct the datafaund to be inaccurate or incomplete and atlempt lo not� past recipients of inaccurate or incomplete data,includrng recipients named by rhe indrvidual;or(b)nol�the indivrdual that he believes the data to be correct. Data in drspute shall be disclosed only if the individual's statement of disagreement rs included tivith the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the adminrstrative procedure act relating to contested cases. DATA PRIVACYADVISORY In accordance wrth M.S.13.04,Subd.2,'Rights ofsubjects ofdata",we tivould lrke to rnform you that your requestforapermrt or license from the City of Orono or any of its deparfinents may require you to furnish cerlain private or confrdenfial information. You are notified that• 1. The information you furnish wi[1 be used to determine your qualifrcation for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the Ciry deny the permit or Ircense. 3. The information may be shared with other local,state or federal agencies to the extent necessary to process the permit or license. 4. If yot�r requested permit or license requires Counci!action to approve,some information may become public. 5. You have certain rights under M.S. 13.04(see following page)to review prrvate data on yourself. 6. Your ful!name is required to process this applrcation or permit. PLEASEPRINT !� � , l ��,�i �M �� C,��1!" First Nliddle Last y��S C� t��QG(wA L,N Address � (�w�� 5'.�s City State Zip Phone I nd r d y �ps �ited a ve. 7 C � ig alure /0