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t Sec.13.0a RIGHTS OF SUBJECTS OF Dr�TA Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set foRh in this section. Subd.2. [nfonnation required to be given individual.An individual asked to supply private or contidential data conceming himselfshall be informed of. (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) �vhedier he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal la�v to receive the data This requirement shal I not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision�,to a law enforcemen[officer. The commissioner of revenue mav place the notice required w�der this subdivision in the individual income tax or property tax reftmd instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is the subject of stored data on individuals,and whether it is classitied as public,private or contidentiaL Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data withou[any charge to him and,if he desires,shafl be informed ofthe content and meaning of that data. After an individual has been sho�vn the private data and intormed of its meaning,the data need not be disclosed to him for six months thereatter 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 of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual cos[s of making,certifying,and compiling the copies. The responsible authority shali comply immediately,if possible,�vith any request made pursuant to this subdivision,or within tive days of the date ofthe request,escluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request within that time,he shall so inform the individual,and may have an additional tive days within which to comply�vith 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 pubfic or private data conceming himse(f. To e�ercise this right,an individual shall notify in writine tlie responsible authority describing d�e 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 notity past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual[hat he believes the data to be correcL Data in dispu[e shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of fhe responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY Iil accordance with M.S. 13.04,Subd.2,"Rights of subjects ofdata",we would like to inforni 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 infonnation. 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 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 inforn�ation 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 A�Iiddle LAst .4ddress City State Zip Phone I understan �ny rig�ts as stated above. � ; •'��`�'/i�--- Signature Reset Form 3?