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� Sec.13.04 RIGHTS OF SLJBJECTS 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. Subd.2. Information req�red to be given individual. An individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data withia the collecdng state agency,political subdivision,or statewide sysum; (b)whether he may refuse ot is legally requimd to supply the requested data:(c)any l�own consequence arising from his supplying or refusing to supply private or confidenrial data;and(d)the idendty of other persoas or enrities authorized by state or fedecal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigaave data,pursuant to section 13.82, subdivision 5,to a law enforcement o�cer. The commissioner of re�enue mav place the nodce required under this subdivision in the individual income taz or property taz refund instructions ins[ead of on those forms. � Subd. 3. Access to data by individual. Upon requcst to a responsible authority,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 subject of stored private or public dara on individuals shall be shown[he data wi[hout any charge to him and,�if he desires, shall be informed of the content and meaning of rhat data. Afrer an individual has been shown[he private data and informed of its meaning,the data need not be disclosed to him for six months thereaher unless a dispute or action pursuan[to this secdon is pending or addidonal data on the individual has been collected or created. The responsibie authority shall provide copies of the private orpublic data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of the da[e of the request,exctuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or compiete. An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise this right,an individual shall nodfy in writing the responsibie authoriry describing the narure of the disagreement. The responsible authority sha►l within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by the individual;or(b)nodfy the individual that he believes the data to be corcect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinadon of the responsible authority may be appealed pursuant to the provisions of the administrarive 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 permit or license from the City of Orono or any of its departments may require you to fumish certain private or confidential information. ' You are notified that: 1. The information you furnish wili 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 pemut 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. �/ � ' '�C �:r i �-� r�� Lh; First Mi e Last -�r- ,��S �-'�'��''S f �t �ti( S' �,C� L�C E Address�l �( ' �Lt/l�, � / � 'L.' '-T C� � �?� / ,��`' �C �LI City �, � � State Zip Phone I understand y ri hts as stated above. � ---------- � `-L�� Signamre