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Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subdivrsion 1. Type ojdata. The rights of individual on whom the data is stored or to be stored sha!!be as set jorth in this section. Subd.2. Injormation required to be given individuaL An individua!asked to supply private or confrdentral data concerning himselj shall be informed of. (a)the purpose and rntended use of the requested data withrn the collecling state agency,polrtical subdivision,or statewide system;(b)whether he may refuse or is lega!!y required lo supply the reguested data;(cJ any knotivn consequence arising from his supplying or refusing to supply private or conftdential data;and(d)the identity ojother persons or entities authorired by state or federal!aw to receive the data. This requirement shall not apply when an rndividual is asked to supply investigative dala,pursuant to section /3.82, subdivision 5, to a law enforcement offrcer. The commissioner ofrevenue may place Jhe notice required under this subdivision in the individual rncome tax or properry tax refund instructions instead of on those forms. Subd.3. Access 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 whether it is classrfred as public,prrvate or confidential. Upon hrs further request,an individual who is the subject oJstored private or public da[a on rndividuals shal!be shoivn the data wilhout any charge to him and, if he desrres,shall be informed of the content and meaning of that data. Af[er an rndividua[has been shotivn the private data and informed of its meaning, the data need nof be disclosed to hrm for six months thereafter unless a dispute or actron purs:iant to this section is pending or addrlional data on the rndividual has been collected or created. The responsible authoriry shall provrde copres of the private or publrc data upon request by the individual subject oj the data. The responsible a:�thoriry may require the requestrng person to pay the actual costs of making,cer[��ing,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to thrs subdivrsion,or lyithin five days of the date of the request,excluding Saturdays,Sundays and lega!holidcrys,if immediate compliance rs not possible. If he cannot comply with the request within that time,he shall so rnform the individ:�al,and m.ay have an additional frve days tivithrn tivhich to comply ivith the request,excluding Saturdays,St�ndays and legal holidays. St�bd.4. Procedure when data is no[accurate or complete.An individual may contest the accuracy or completeness oJpublic or private data concerning himself. To exercise this right, an individua!shall not�in writing the responsible authority describing the nature of the disagreemenl. The responsible a:�thorityshall wrthrn 30 days either: (a)correct the datafound to be inaccurate or incomplete and attempt to not� past recipients of inaccurate or incomplete data,including recipients named by the rndrvidual;or(b)notify the individual that he believes the data to be correcl. Data in dispute shal!be disclosed only if the rndividual's statement of disagreement is included tivith the disclosed data. The determrnation of the responsrble authorrty may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACYADVISORY In accordance with M.S.13.04,Subd.2, "Rights of subjects ofdata",we would like to inform you thatyotirreqt�est for a permrt orlrcense from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: \ I. The information you jurnish 1vi11 be used to determine your qualificatron for Ihe permit or license requesled. 2. You may refuse to supply data,but refusal may require rhat the Crty deny the permit or license. 3. The informalion may be shared ivilh other local,state or federal agencies to the extent necessary to process the pennit or license. 4. If your requested permit or lrcense requires Council aclion to approve,some information may become publrc. 5. You have certarn rights under MS. 13.0�(see folloiving page)to review prrvate data on yourself. 6. Your full name is required to process this application or permit. PLEASE PRINT ��'r►,��,� ��c V l4'�1.c�c.��/�L First Middle Last 3�� ,�,�I�. �2� �c/ Address L(/'�-/Z/-�� il/ S�3�/ GlZ- �Fs,�'2 5 �S� City State Zip Phone as stated above. /0