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Sec.13A4 RIGFITS OF SUBJECTS OF DATA Subd. I. 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. Infonnation required to be given individual. An individual asked to supply private or contidential data concerning himselfshall be informed of: (a)d�e purpose and intended use of the requested data�vidiin the collecting state agency,political subdivision,or statewide systeirr,(b) whether he may refuse or is legally required to supply the requested data;(c)any kno�mn consequence arising from his supplying or refusing to suppl}' private or confidential data;and(d)the identity of other persons or entides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant[o section 13.82,subdivision 5,m a law enforcement officer. The commissioner of revenue mav olace the notice reguired under this subdivision in die individual income tax or property tax refund instntctions instead of on those forms. Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be intbrmed whether he is tl�e subjectof stored dafa on individuals,and whether it is classitied as public,private or contidential. Upon his YLrther request,an individual who is the subject of stored private or public data on individuals shall be shown[he data�vithout any charge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been sho��n the private data and informed of its meaning,the data need not be disclosed to him for si� months thcreafter unless a dispute or action pursuant to this section is pending or additional dafa on the individual has been collected or created. The responsiblc authority shall provide copies ofthe privace or public data upon request by the individual subject ofthe data The responsible authority may require the requesting person to pay the actual costs of making,certityine,and compiling the copies. The responsible authority shall comply immediately,it possible,with any request made pursuant to this subdivision,or within tive days oL the date ofthe request,escluding Saturdays,Sundays and legal holidays,ifimmediate compliance is not possible. Ifhe cannot comply�vith the request �vithin that time,he shall so infonn the individual,and may have an additional five days within which to comply with the request,esdudine Saturdays, Sundays and legal holidlys. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data conceming himselt. To exercise this right,an individual shall notify in wTiting the responsible airthority describing the nature of the disagreemenL The responsible authority shall within 30 days ei[her. (a)correct d�e data found to be inaccurate or incomplete and attempt to notifi�past recipients 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 statemenc of disaereement is included with the disclosed data. The detennination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relatine 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. Tl�e inforn�ation you furnish will be used to determine your qualification for the permit or license requested. ?. Yuu n�ay refuse tv supply data,but refusal may require that the Ci y der�y the pern�it cr licerse. 3. The information may be shaced with other local, state or federal agencies to the extent necessary to process the pern�it or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have cectain rigllts under Nt.S. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. First liiddlc Last Address Cit� State "Lip Phonc I understand my rights as s�ated above. � � Si�naturc Reset Form .i�