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Sec.13.04 RIGHTS OF SUBJECTS OF DATA � Subd. 1. Type oF data. The righu of individual on whom the data is stored or to be stored shall be as set forrh in this secdon. Subd.2. Information required to be given individual. An individual asked to supply private or confidencial data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency, poti�cal subdivision,or statewide rystem;(b)whether he may refuse or is legally required to supp(y the requested data;(c)any tmown consequence arising from his supplying or reiusing to supply private or confidenaal dara;and(d)the idendty of other persons or enaries authorized by smte or federal law to receive[he data. This requirement shall not apply when an individual is asked to supply investigadve data, pursuant to secaon 13.82, subdivision 5, to a law enforcement officer. 'Ihe commissioner of revenue mav�lace the norice reouired under this subdivision in the individual income taz or orooertv tax refund insttucrions mstead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsibie authoriry,an individual shall be informed whether he is the subject of stered data on individuals,and whether it is c(assified as public,private or confidenrial. 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 the contenc and meanin�of that data. After an individual has been shown the private data and informed of its meaning, the data need not be disclosed to him for six months thereafrer unless a dispute or acdon pursuant to this secaon is pending or addirional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible au[hority may require the requesdng person to pay the actual costs of making,certifying, and compiling the copies. The responsibie authoriry shall comply immediately,if possible,with any request made pursuant[o this subdivision, or wirhin five days of the da[e of the request,excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comp(y with the request within that dme, he shall so inform the individual, and may have an additional five 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 of public or private dara concerning himself. To execcise this right,an individuai shall notify in writing the responsiblz authoriry 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 noafy past recipiencs of inaccurate or incomplete daCa,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shali be disclosed only if the individual's stacement of disagreement is included with the disclosed data. The determinadon of rhe respoasible authoriry may be appealed pursuant to the provisions of the adminis�aave procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with Nf.S. 13.04, Subd. 2, "Righ[s 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 Ciry 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 pernut 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) ro review private data on yourself. 6. Your full name is required to process this application or permit. Firsc Midd(z Last Address C��' Srate Zip Phone I und r and y ights as s ov . - Signatu � 6