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� Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. SuUd.2. Infonnation required to be given individuaL An individual asked to supply private or confidential dataconcerning himselfshali be informed ofl. (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any kno�vn consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when 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 place the notice required under this subdivision in the individual income tas or property ta�refund instructions instead of on those forms. SuUd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be intiormed whether he is the subject oY 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 widlout 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 p�ivate data and informed of its meaning,the data need not be disclosed to him for si� months thereafter unless a dispute or action pursuant to this section is pendine or additional data on the individual has been collected or created. The responsible authoriN 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 costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with an}'request made pursuant to this subdivision,or within tive days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he ca�inotcomply with the request within that time,he shall so inform the individual,and may have an additional tive days�vithin�vhich to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.a. Procedure when data is not accurate or complete. An individuaf may contest the accuracy or completeness of public or private data concerning himself To e�ercise[his right,an individual shall notify in writing the responsible authority describing the natu�e ofthe disagreement. The responsible auchoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomple[e data,including recipients named by the individual;or(b)notify the ittdividual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's stafement of disagreement is included 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",we would like to inform you that your request for a perniit or license from the City of Orono or any of its departments may re�uire you to furnish certain private or confidential information. You are notified that: 1. The inforn�ation you furnish will be used to detennine 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 Coiulcil action to approve, some infonnation may become public. 5. You have certain rights under M.S. ]3.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. First �1iddle LASf �� r��ss Cit}� /�t�te Zio Phone 1 understand my rights as stat�ed nUove.,� ��, .� .� �. � ignature �?