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V Sec.13.04 RIGHTS OF SUBJGCTS OP DATA Subd. L Type of data. The riglits of individual on whom die data is stored or to be stored shall be as set forth in this section. Subd.2. Infonnalion required to be given individual. An individual asked to supply piivate or confidential data conceming himself shall be infonncd of: (a)the puipose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required ro supply the requested data;(c)any kno�wi consequence arising fiom his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities aulhoiized by state or federal law[o receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The coinmissioner of revenue ma�place the notice required under this subdivision in the individual income tax or propeitv tax refund insWctions instead of on those fonns. Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual sha11 be infonned whether he is the subject of stored data on individuals,and whether it is classitied as public,private or contidentiaL Upon his further request,an individual who is the subject of s[ored private or public data on individuals shall be sho�m the data withoul any charge to him and,if he desires,shall be infoimed of the content and meaning of that data. A14er an individual has been shrnm the private data and infonned of its meaning,the data necd not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on tlte individual has been collected or created. llie responsible authority shall provide copies of the private or public data upon�equest by the individual subject of the data. The responsible authority may require the requesling person to pay the actual costs of making,ceitifying,and compiling the copies. The responsible authoiity shall compty immedia[ely,if possible,with any request made pursuant to this subdivision,or within five days of the date of the reques[,excluding Salurdays,Sundays and legal holidays,if immediate compliance is not possible. if he cannot comply with[he request wilhin that time,he shall so infonn lhe individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedw e when data is not accurate or complete. An individual znay contest the accuracy or completeness of public or priva[e data concerning himself. l o exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disa�eement. The responsible authority shall within 30 days either. (a)con'ect the data found to be inaccurate or incomplete and attempt to notify p�st recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notity the individual diat he believes the data lo be con ect. Data in dispute shall be disclosed only if the individual's statement of disagreement is ind�ded with the disclosed data. The detennination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act mlating to contested cases. llATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to infornl you that your request for a pennit or license fi�om the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: L The infonnation you furnish will be used to detennine your qualification for the pennit or license requested. 2. You may refuse to supply data,but refusal may require tliat the City deny the permit or license. 3. The inforn�ation may be shared with other local, state or federal agencies to the extent necessary to process the pennit or license. 4. If your requested peiYnit or license requires Council action to approve, some infoimation may become public. 5. You liave certain rights under M.S. 13.04 (available upon request)to review private data on yourself. 6. You full name is required to process this appli �on or peinlit. � First I��Lddle Last e<< � ^ Address �ity State Zip Phone I undei•stand my rigllts as ate � e. � _ Signature ;�