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� Sec.13.04 RIGH'I'S OF SUBJECTS OF DATA Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set for[h in this secdon. Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and in[ended use of the rEquested data within the collecting'state agency, polidcal subdivisio�,or statewide system; (b)whether he may refuse or is leeally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identiry of other persons or entiries authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigaave da[a, pursuant to secaon 13.82, subdivision 5, to a law enforcemen[o�cer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propem tax 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 whe[her he is the subject of stored data on individuals, and whe[her it is classified as public, private or confidential. Upon his funher request, an individual who is the subjecc of stored private or public data on individuals shall be shown[he data wichout any charge to him and,'if he desires, shall be informed of the content and meaning of that data. After an individual has been shown[he private data and infocmed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authority shall provide copies of the private or pub(ic data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costs of making, cerrifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any reques[made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the reques[ within that time,he shalt so inform[he individual,and may have an addidonal 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 private data concerning himself. To exercise this right,an individual shalt notify in writing the responsible authoriry describing the nature of[he disagreement. The responsible authoriry shafl within 30 days either. (a)correcc the data found to be inaccurate or incomplete and attempt to norify 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 statement of disagreement is included with the disclosed data. 'I"ne determinadon of the responsible authoriry may be appealed pursuant ro the provisions of the administracive procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance wi[h 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 fumish 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 Ciry deny the permit or license. 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 your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.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 Middle Last Address Ciry , , State Zip Phone � � I understand r�y rights as ' tated ab,pve. \ A S - � 1\ � Signature