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♦ . ♦ Szc.13.04 RIGHTS OF SUB.TECTS OF DATA - Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given individual. An individual asked to supply privare or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested dara within the collecting state agency,polidcal subdivision,or statewide syscem:(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusiug ta supply private or confidendal dara;and(d)the idenury of ocher persons or enddes authorized by snte or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav olace the norice reauired under this subdivision in the individual income taz or orooertv tax refund instrucrions 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 classified as pubiic,private or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any char;e to him and, if he desires,shall be informed of rhe content and meanin�of that data. Afrer an individual has been shown the private data and informed of its meaning, the data need not be disclosed co him for six months thereafrer unless a dispute or acdon pursuant to this secaon is pending or addiaonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of che data. The responsible au�horiry may require the requesring person to pay the actual cosu of making,certifyin„and compiling the copies. 'Ihe responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Sacurdays, Sundays and legal hotidays, if immediate compliance is not possible. If he cannot comply with the request wichin that time, he shall so inform the individual, and may have an addidonal five days within which to comply with the request, excluding Saturdays,Sundays and legal ho(idays. Subd.4. Procedure when data is not accurate or complete. An individual may concest the accuracy or completeness of public or private dara conceming himself. To exercise ttus right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomple[e dara,including recipients named by the individual;or(b)nodfy the individual thac 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 determinadon of the responsible au[horiry may be appealed pursuant to the provisions of the adminisQauve procedure act relating ro 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 tha[the City deny the permit or license. 3. The information may be shared with other local, state or federal a?encies to the extent necessary to process the permit or license. 4. If your requested permit or licease 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 [his application or permit. First Middlt Last Address ��Y State Zip Phone I understand my rights as stated above. Signature 6