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. i Sec.13.0� RIGHTS OF SLJB.JECTS OF D.aT,1 Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set for[h in this secrion. Subd.'_. Information required to be given indiridual. �.n individual asked to supply private or con£idential data conceming himself shall be informed of: (a)the purpose and in[ended use of the requested dara within the collecting'state agency, political subdivisio�,or statewide system; (b)whecher he may refuse oY is legally required ro supply the requested data:(c)any known consequence arising from his supplying or refusing to supply priva[e or confidential data;and(d)the iden[ity of other persons or entiaes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesaeadve data, pursuant to secaon 13.82, subdivision�, to a law enforcement officer. The commissioner of re�enue mav place the norice reauired under this subdivision in the individual_income tax or propertv tax refund instructions insread of on those forms. Subd. 3. Access to data by indi�ldual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals, and whe[her it is classified as public, private or confidendal. Upon his further request, an individual who is the subjec[ of stored private or public data on individuals shall be shown[he data without any charge to him and, if he desires, shall be informed of the content and meaning of rhat data. After an indi•+idual has been shown the private data and informed of its meaning, che data need not be disclosed to him for six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authority shall provide copies of the privace or public data upon requesc by the individual subjec[of the data. The responsible authoriry may require the requesting person to pay che actual cosu of making, certifying, and compiling [he copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of [he date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request wi[hin that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Sarurdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise[his rieht,an individ�al shall nodfy in wri[ing the responsible authority dzscribing[he nature of the disagceement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to norify past recipienu of inaccurate or incomplete data, including recipiencs named by [he individual; or(b)notify the individual tha[he believes the data to be correct. Data in dispu[e shall be disclosed only if the individual's statemen[of disagreement is included with the disclosed data. The de[emtination of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�hts of subjects of data' , we would like to inform you that your request for a pernut 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 pemut or license requested. ?. 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 pernut or license. 4. If your requested pernut or license requires Council action to approve, some information may become public. j. 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. �a � ��-� 5�.,.� ,�z ��,�� , First Middle Lasc ,�s y � s�� 5 Address G�� C� � ,�",.�� j� � �t �� C —�S�i �j'! C � , City State Zip Phone I underst my ri hts as stated _ -�-�� . Signam e _