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, � , Sec.13.04 RIGHTS OF SUB.TECTS OF DATA Subd. 1. Type of data. The rights 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 individual asked to supply privau or confidential data concerning himself shall be informed of: (a) the purpose and intended use of the requested data within the collecang�tate agency, polidcal subdivision,or statewide system; (b)whe[her he may refuse or is legally requued to supply the requested data;(c)any]mown consequence arising from his supplying or tefusing to supply private or confidendal data;and(d)the idendty of other persoas or endaes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply mves6gadve data,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. 1"he commissioner of revenue mav place the norice required under this subdivision in the individual income tax or propertv taz refund instrucrions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or co�denrial. 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 hun and, if he desires, shall be informed of the content and meaning of that dan. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for siz months thereafter unless a dispute or action pursuant to this secdon is pending or addiaonal dara 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 authoriry may require the requesting penon to pay the actual costs of making,cerafying,and compiling the copies. 'I�e responsible authority shall comply immediately,if possible, with any request made pursuant to this subdivision,or wi[hin five days of the date of the request,ezcluding Saturdays,Sundays and legal holidays,if unmediate compliance is not possible. 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,ezcluding Sarurdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuncy or completeness of public or private data concerning himself. To exercise this right,an individual shall noafy in wriang the respoasible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplete and attempt to nodfy pas[recipienu of inaccurate or incomplete data, including recipienu named by the individual; or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disa;reement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the admuustrative procedure act relacing 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 confidential 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 local, state or federal a?encies to the extent necessary to 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 ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to rocess this application or ermit. �� -� / Ficst Middle st Address Ciry State Zip Phone I under t y right as tated ba . .�� �� Signacure