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Sec.13.04 RIGHTS OF SLJB.TECTS OF DATA Subd. 1. Type of data. The righrs of individual on whom the data is stored oc ro be stomd shall be as set forth in this secaon. Subd.2. Information req�rired to be give°md�v�dual' p'°�ndividual asked to supply private or confidendal data conceining himself sha11 be informed of: (a)the purpose and inrended use of the requested data within the collecdng'state agency,polidcal subdivision,or statewide symm: (b)whether he may refuse or is legally requiied to supply the ceQuested data;(c)any known coasequence arising from his supplying or refusing co supply private or confidenaal dara;and(d)che idenary of other persons or entiaes authorized by state or federal law to receive the dara. This requirement shatl not apply when an individual is asked to supply investigaave dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav lace the nodce re uired under this subdivision in the individual income tax or rooem taz refund inscrucaons instead of on those forms. Subd. 3. Acccss to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals, and whe[her it is ciassified as public, private or confidential. Upon his further request, an individual who is the subject of stored private or public dara on individuals shall be shown the data without any charge to him and, if he desires, shall be informed of the con[en[ and meaning of that data. After an individual has been shown[he private data and informed of its meaning,the data need not be disclosed to him for six months thereaf[er uniess a dispute or acrion pursuant to this secaon is pending or addidonal data on the individual has been collected or crea[ed. The responsible auchoriry shall provide copies of the private or public data upon request by che individual subject of the data. The responsible authoriry may require the requesang person to pay the actual cosu of making, cerrifying, and compiling the copies. The responsible auchority shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediace compliance is no[possible. If he cannot comply with the requesL within[hat time,he shall so inform the individual,and may have an additional five days wi[hin 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 accuncy or completeness of public or privace data conceming himself. To ezercise this right,an individual shall notify in wridng the responsibie authonry describing the narure of the disagreemen[. The responsible au[hority shall within 30 days either: (a)correct the data found to be inaccurate or incomp(ete and attempt to nodfy past recipieau of inaccutate or incomplere data, including recipiencs named by the individual;or(b) noufy 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. The determu�ation of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relating to contesced 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, The information you furnish will be used to detemiine your qualification for the pemut or license requested. 2, You may refuse to supply data, but refusal may require that the City deny the pernut or license. 3, The information may be shared with other local, state or federal agencies to the extent necessary to process the permi[ or license. 4. If your requested permit or license requires Council action to approve, some information may become public. j, You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. (, Your full name is required to process this application or permit. � l � ` � �-T I�ZTU Y'YYl�C��1 �'►Tr�L� G� �tiddlen � �t F�� KD � Y' � A�ress �' � 1� ��C� 1 '"l � � " l�� L � State Z�p Phone Ciry u derstand my rights as stated above. C�,�� 1..��LK-�'�� Signamre