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.�. � Sec.13AA R[GH'I'S OF SUI3JF,CTS OF DATA Suhd.1. Type of data. The rights of individual on whom die data is stored or to he srored shall be as set forth in this section. Subd.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use ofthe requested data�vithin the collecting state agency,politica]subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known conseque�nce arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized b}�state or federal law[o receive the data. This requirement shall not apply�vhen an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax o�roqertv tax refund instructions instead of on those fomis. 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�vhether it is classified as public,private or confidential. 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 charge to him 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 its meaning,the data need not be disdosed 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 collected or created. The responsible authority shall provide copies ofthe private or public data upon request by the individuai suhject ofthe data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturday�s,Sundays and legal holidays,if�mmediate compiiance is not possible. If'the cannot comply with the request within that time,he shal I so inform the individual,and may have an additional five days within which to comply with the request,excluding Samrdays, Sundays and legal holidays. Subd.4. Procedure�i�hen data is not accurate or complete.An individual may contest the accuracy or completeness ofpublic or private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreemenL The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bclieves the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagrcement is induded with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",�ve 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 i'urnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusa] may require that the City deny the permit or license. 3. The informatio❑ may be shared �vith 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. T!'� �j c h � /1 �C. First Middle Last ll :�� a u �c n s.��u � ��r�ss �j�vu/'�lln �� 0 C��y State Zip Phone I understand my rights as stated above. �— Sign re 3?