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Sec.13.04 RIGHTS OF SUB.TECTS OF DATA Subd. 1. Type of data. The righcs of individual on whom the dara is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual uk�w supply private or confidential dara concerning himself shall be informed of: (a)the purpose and intended use of the requested dara within the collecting srate agency,political subdivision, or statewide system; (b) whether he may refuse or is legally required to supply the cequested data; (c)any known coasequence arising from his supplying or refusing to suppty private or confidendal dara; and(d)the idendty of other persons or enuties authorized by state or federal law to receive the dara. Ttus requirement shall not appty when an individual is asked ro supply invesdgative data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of ievenue mav place the nodce ieQuimd under this s�bdivi9en in the individual income taz or oropertv ta�c refund instrucdons instead of on those forms. Slibd.3. Acces to data by mdividual. Upon request to a responsible authority, an individual shall be informed whether he is the subject of stoced data on individuals,and whether it is ciassified as public,private or confidendal. tipon his further request, an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to h�and, if he desires, shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of ia meaning, the data need not be disclosed ro him for siz months thereafter u�iless a dispute or action pursuant to dvs section is pending or addiriooal daa on the mdividual 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 authoriry may require the requesting person to pay the actual costs of making, certifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, wirh any rer,uest made pursuant to this subdivision,or within five days of the date of the cequest,excluding Satuttlays,S�uidays az�d legal holidays, if immediate compliance is not possible. If he cannot comply wiih the request within that dme,he shall so inform the individual, and may have an addidonal five days within which o�comply with the request, excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is noi accuiate or complete. An mdividual may contest the accuracy or completeness of public or private data conceming himself. To ezercise this right, an individual shall nodfy in wriring the respoasible authoriry describing the nature of the disagreement. The �sponsible authority shall within 30 days either. (a)correct the data found to be inaccun,.�or incomplete and attempt to notify past recipients of inaccurate or incomplete data, including recipienu named by the individual;or(b)nodfy 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 included with the duclosed dara. The detemunadon of the cesponsible authoriry may be appealed pusuant m the provisions of the administradve procedure act relating to contested cases. DATA PRIVACY AD`ZSORY 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 fumish certain private or confidential information. You aze notified that: 1. The inforrnation you fumish 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 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 City State Zip Phone I understan m}r�ri t as ed above. " I � � Signature 10