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.► Sec.I 3.04 RIGHTS OF SUBJECTS OF DATA Subd. I. Type of data. The rights o(individual on whom the data is stored or to be stored shall be as set torth in this secticn. Subd. 2. Information required to be given individual. An individual asked to supply private or confidential data con�:rning himself shall be informed of: (a) the purpose and intended use of the requested data within the collecting state agency, political subdivision, or :tatew�de system; (b) �shether he may refuse or is legally required to supply the requested data; (c) any known consequence arising from his supplyin,or refusing to supply pritiate or confidential data; and (d) the identity of other persons or entities authorized by state or federal law to recei�e the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section I 3.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propertv ta�c refund instructions instead of on those forms. Subd. 3. Access to data by individuai. Upon request to a responsible authority, an individual shall be informed �stz�her he is the subject of stored data on individuais, and whether it is classified as public, private or confidential. Upon his further request, an indi��du:il who is the subject of stored private or public data on individuals shail be shown the data �vithout any charge to him and, if he desires, shall be inforr..� of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning, the data need not be d_�:losed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been colk:ed or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The r�ronsible authority may require the requesting person to pay the actual costs of making,certi(ying,and compiling the copies. The responsible authority shall comply immediately, if possible, with any request made pursuant to this subdivision, or xithin fi��e days of the date of the request, excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot compl� w=th the request within that time, he shall so intorm the individual, and may have an additional five days within which to comply with the request, excludW;Saturdays, Sundays and legal holidays. Subd. 4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completer.�of public or private data concerning himself. To exercise this right, an individual shall noti�y in writing the responsible authority describing the naturz of the disagreement. The responsible authority shall within 30 days either: (a) correct the data found to be inaccurate or incomplete and attempt to r.ctif�� past recipients of inaccurate or incomplete data, including recipients named by the indi�iduai; or (b) noti�y the individual that he belie��es 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 determination of the responsible authority may be appealed pursuant to the provisions oi the administrative prcc:dure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with N1.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 �icense 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 ma�� become public. 5. You have certain rights under 1VI.S. 13.04 (available upon request) to review private data on�-ourself. 6. Your full name is required to process this application or permit. First hliddle Last Address City State Zip Phone I understand my rights as stated above. Sia ature