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�� J� Sec.13.04 RIGHTS OF SUBJECTS OF DATA � �'� �� Subd. 1. Type of data. The rights of individual on whom tl � �/ � Subd.2. lnformation required to be given individual. An ind /� �all be informed of. (a)the purpose and intended use ofthe requested data wit ��"�� n;(b) whether he may refuse or is legally required to supply the requested dat� upply private or confidential data;and(d)the identity of other persons or entit t shal I not apply when an individual is asked to supply investigative data,pur The commissioner of revenue mav olace the notice reauire �efund instructions instead of on those forms. Subd.3. Access to data by individuaL Upon request to a re� gect of stored data on individuals,and whether it is classified as public,privati ject of stored private or public data on individuals shall be shown the data wit mt and meaning of that data. After an individual has been shown the private c for six months thereafter unless a dispute or action pursuant to this section is E d. The responsibie authority shall provide copies of the private or public data upon request by the individual sub�ect oi the oara. i ne�espu��a,.thority may require the requesting person to pay the actual costs of making certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional fivc 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 ofpublic or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify 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 induded with the disclosed data. The determination of the responsibie authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 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 C�t?' State Zip Phone I understand�y ri�h�as stated ve. � %/ �'� , �/ � Signature � r Reset Forn� 32