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Sec.13.04 RIGH'I'S OF SUB.TECTS OF DaT,�, Subd. 1. Tvpe of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secrion. Subd.'_. Information reqtrired to be given individual. An individual asked to supply privatE or confidendal data concerning himself shall be informed of: (a) the purpose and intended use of the requested data within the collecting'state agency,political subdivision,or statewide rystem; (b)whether he may refuse oY is legally required to supply the reques[ed data;(c)any laiown consequence arising from his supplying or refusing to supply private or confidencial data;and(d)the idenary of o[her persons or enriaes au[horized by state or federal law to receive the data. This requirement shali not apply when an individual is asked to suppiy invesdeaave dan, pursuant to secaon 13.82, subdivision 5, to a law enforcement ofFicer. The commissioner of re`enue mav place the nodce reouired under this subdivision in the individuai income tax or propertv tax refund instructions instead of on those forms. Subd. 3. Access to data by indi�ldual. Upon request to a responsible au[horiry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public, private or confidendal. Upon his fur�he�reques[, an individual who is the subject of stored private or public data on individuals shall be shown[he data wichout any charge to him and, if he desires, shall be informed of the content and meaning of[hat data. Afrer an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to hun for six months therea8er unless a dispute or acrion pursuant to [his secdon is pending or addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the priva[e or public data upon request by the individual subject of the data. The responsible authoriry may require che requesting person to pay the acnial coscs of making, certifying, and compiling the copies. The 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 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 addiaonal five days within wtuch to comply with the request,exc(uding Sarurdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compleceness of public or pri�•ate dara concerning himself. To exercise[his right,an individual shall nodfy in wriring the responsible authori[y describing�he nacure of the disagreement. The responsible authoriry shall within 30 days eithe�: (a)correct the data found to be inaccurate or incomp(ete and attempt to nodfy past recipienrs of inaccurate or incomplete data, induding recipients named by the individual; or(b)nodfy the individual that he believes the data to be correct. Data in dispu[e shall be disclosed only if the individual's statement of disagreement is includzd with the disclosed data. T}ie decerminarion of the responsible authoriry may be appealed pursuan[to the provisions of the administrarive procedure act relating to contesred cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Riahts of subjects of data", we would like to inform you that your reauest 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 pemut or license. 3, The information may be shared with other local, state or federal a�encies to the ex[ent necessary to process the permi[ or license. 4. If your requested permit or license requires Council action to approve, some information may become public. j. You have cectain 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 City State Zip Phone I understand my ri;hts as stated above. SignaNre