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� ' �'' . _ - .- - �� Sec.13.04 RIGHTS OF SLIBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is storcd or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given lndiridual. M individual asked to supply private or confidendal data concerning himself shali be informed of: (a)the purpose and intended uu of the requested data within the collecdng State agency, poliucal subdivision,or statewide system; (b)whecher he may rcfuse or is legally required to wppty the'requesud data;(c)any known consequence arising frotn his supplying or refusing to3upply private or confidential data;and(d)the identi"ty"of other persons or en6ties authorized by state or federal law to receive the data. This requirement shall not appiy when an individual is asked to supply invesdgaave data, punvant ro section 13.82, subdivision 5, to a law enforcemenCofficer. The commissioner of revenue mav �lace the noace rcauired under this subdivision in the individual income tax or oronertv tau refund inscrucaons instead of on those forms. Subd.3. Accas to data by indIridual. Upon request to a cesponsible authority,an individual shall be informed whether he is the subject of srored data on individuals,and whether it is classified as public,private or confidenaal. Upon 6is further�zquest,an individual who is the subject , of storcd private or public data on individuals shall be shown rhe data wichout,any charge to him and, if he desires, shall be informed of the content , and meaning of that data. Afur'an individual has been shown the private data and informed of its mr ��g,[he data need not be disclosed ro him for siz monchs thercafter unless a dispute or acdon pursuant to this secrion is pending or addidonal data on the individual 6as been collected or created. The responsible authority shall provide copies of the private or public data upon rzquest by che individual subject of the data. The responsible authoriry may requirc the requesting person to pay the utual costt of making,certifying,and compding the copies. The responsible authoriry shall comply immediatety, if pouible, with any rcquest made punuant to this subdivision,or within five days oF the date of the requut,excluding Saardays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request wichin�hat time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,ezcluding Saturdays, - Sundays and legal holidays. - Subd.4. Procedure when data is not accurate or complete. An individual may contest the accurecy or completeness of public or private data concerning himself. To ezereise this righ[,an individual shall notify in writing the responsible authoriry des:ribing the nature of the disagrcement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and aaempt to noRfy past recipients of inaccuate 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 orily if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuanc co the provisions of the administrative procedure act relaang 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 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 determine 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 information may be shared with other local, state or federal agencies to the eztent 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. �i'1 i� L� �Y1G . First . c Middle Last - tC�?�� V�`��hG 1�'r � IOS Addrcss �N� �ra.�r�e_ h�n , 553A�( q44 �--q4q9 City State Zip Phone [ e d my rights as stated ab v . ' � � �0��, ylG� ignaNre �