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. . �� . Sec.13.04 RIGHTS 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. Intonnation required to be given individual. An individual asked to supply piivate or confidential data conceming himself shall be infonned of: (a)the purpose 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 to supply Qle requested data;(c)any known consequence arisin�from his supplying or refusing to suppty private or confidential data;and(d)the identity of other persons or entitics 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 to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may place the notice required under this subdivision in the individual incorne tax or property tax refund instructions instead of on those fonns. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his fur[her request,an individual who is the subject of s[ored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be infonned of the content and meaning of that data. After an individual has been shown the private data and infonned of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pw suant to[his section is pending or additional data on tlte individual has been coilected or created. 7lie responsible authority shall provide copies oPthe private or public data upon request by the individua(subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible autho�ity shall comply i�mnediately,if possible,with any request made pursuant to this subdivision,or within five days of the date oY the request,excluding Saturdays,Sundays and legal holidays,if immediate canpliance is not possible. If he cannot comply with the request within that time,he shall so infonn the individual,and may have an additional five days within which to comply with the 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 piivate data concerning himself. To exercise tliis right,an individual shall notity in writing the responsible authority describing the nature of the disa�eeinent. The responsible authority shall within 30 days either: (a)con�ect the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incoroplete data,induding recipients named by the individual;or(b)notify the individual that he believes the data lo be con'ect. Data in dispute shall be disdosed only if the individual's statement of disagreement is included with the disciosed data. The detennination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISOKY In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to infonn 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 infonnation you funiish will be used to detennine 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 infoiniation may be shared with other local, state or federal agencies to the extent necessary to process the pennit or license. 4. If your requested permit or license requu�es Council action to approve, some infoimation may become public. 5. You have certain rights under M.S. 13.04 (available upon request)to review private data on yourself. 6. Y ur full name is required to pr cess this a lication or permit. � First NLddle Last ��C� ll , � Address �— -�C�/ !�� S�_ ..J.� y -� �ity Statc Zip Phone ,'� /' I understand my r'sllts a t e��. � ( �, Signature r____ ;�