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� Sec.13.04 RIGHTS OF Si1B.1ECTS OF D�.T� Subd. 1. Type of data. "Ihe righ�s of individual on whom the data is scored or to be stored shall be as sec fonh in this secrion. Subd.2. Information reqirired to be given indi�-idual. An individual asked to supply private or confidenrial dara concerning himself shall be informed of: (a)the purpose and inrended use of the reques[ed dara within the collecting'stace agency,polidcal subdivision,or sta[ewide system; (b)whe[her he may refuse oY is legally requic�d to supply the requested data;(c)any lmown coasequence arising from his supplying or refusing to supply • priva�e or confidendal data;and(d)the idenary of ocher persons or enrides au[horized by sta[e or federal law to receive the data. 'Ihis requiremenc shall not apply when an individual is asked to supply invesdeadve dara, pursuanc to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav plaee the noace reouired under this subdivision in the individual income tax or prooem tax refund instrucdons ins[ead of on�those forms. . Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of scored data on individuals,and wherher ic is classified as public, privace or confidendal. Upon his further request, an individual who is the subjecc of stored private or public data on individuals shall be shown the data wichout any charge to him and, if he des'ues, shall be infoaned of the contenc and meaning of chat data. Afrer an individual has been shown the private data an8 informed of its meaning,the data need not be disclosed to him for six monchs thereaiter unless a dispute or acrion pursuanc to �his secaon is pznding or addidonal data on the individual has been collected or creaced. 7he responsible authoriry shall provide,copies of[he private or public data upon request by the individual subjecc of�he dara. The responsible authoriry may require the requesring person to pay the actual costs of making, certifying,and compiling the copies. • The responsible authoriry shall comply immediately, if possible, with any r�quest made pursuant to this subdivision,or within five days of the date of the requesc,excluding Saturdays,Sundays and legal holidays,if immediace compliance is noc possible. If he cannot comply with the requesc within chac time,he shall so info�rn che individual,and may have an addidonal five days within which to comply wi�h the request,exctuding Saturdays, Sundays and�legal holidays. t, • . Sub�S.A. �'rocedure when data is not accurate or complete. An individuat may conrest'the accuracy or comple[eness of public or pm•are data concerning himsetf. To execcise this right,an individual shall nodfy in writing the responsible authoriry describing the nacure of the disagreement. The responsible authoriry shall within 30 days either. (a)correcc the data found ro be inaccurate or incomplece and attempt to nodfy past recipienes of inaccunte or incomplete data, including recipients named by the individual; or(b) notify the individual that he believes the data ro be corcect. Data in dispute shall be disclosed only if the individual's statemen[of disagreement is included with the disclosed data. The decerminarion of[he responsibte auchoriry may be appealed pursu'anc to the provisions of[he admuilscrative 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 Ciry of Orono or any of its departments may require you to furnish cer[ain private or confidential information. You are notified that: 1. The information you furnish will be used to d.e[ermine your qualification for the permit or license requested. 2. You may refuse to supply data, bur`refusal may require that the City deny the permit or license. 3. The information may be shared wich other local, state or federal agencies to the extent necessary to process the pemut or license. 4. If your requested pernut 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 �tiddle Lasc Address City State Zip Phone I understand my ri�hts as stated above. . Signature