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Sec.13.04 RIGHTS OFSUBJECTS OFDATA Subdivision 1. Type ojdat2 77te�ights ojindividua!on whom the data is stored or to be slored shall be as set jorth in lhis section. Subd.2. Information required to be given individuaL An rndrvidual asked to supp[y private or canfidential data concerning himse f shall be injormed oj (a)the purpose and intended use of the requested data within the collectrng state agency,political subdivision,or statewide system;(b)whether he may rejuse or is legally requrred to supply the requesled data;(c)mry lorown consequence arising from hrs supplying or refusinglo supply private or confidential data;and(d)the idenlity of other persons or entities authorized by state orjederal!aw to receive the data. Thrs requirement shall no1 apply when an indrvidual is asked to supply imestigative dala,pursuant to section 13.82, subdivisron S, lo a Imv enjorcement o�cer. The commissione�ofrevenue may place the notrce requi�ed under this subdrvision in the indivrdual income tax or property tax refund irutructioru instead of on those forms. Subd.3.Access to data by individuaC Upon request lo a resporrsib/e authority,an rndrvidual shall be informed whether he is the subject of stored data on individuals, and whether it is clarsrfred as public,private or confidential. Upon his further request,an individual who rs!he subject ojstored private or public data on individuals shall be shown the data wrthout arry charge to hrm and,if he desires,shall be informed of the conlen!and meanrng of that data. Ajter an individual has been shown the private dala and injormed ojits meaning, the data need not be disclosed fo him for six months lhereajter unless a dispute or action pursuant lo this seclion rs pendrng or additroxal data on the individua!has been collected or created. The responsible authority shal!provrde copres ojthe prrvate or public data upon request by the individual subject of the data. The responsrble authority may requrre the requesting person to pay the actual costs of making,cert�rng,and compiling the copies. The responsible authoriry shall comply immediately,rfpossible,wrth arry reques�made pursuant to this subdivrsron,or withrn frve days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate complrance is not possrble. Ijhe cannot comply wrlh the request within that 1ime,he sha11 so inform the individual,and may have an additional frve days tivithin which to comply with the request,excluding Saturdays,Sundays and lega!holidays. Subd.4. Procedure when data is not accurate or complete An rndividual mcry contest the accuracy or completeness ojpublic or private data concerning hrmself. To exercise this right, an individua!sha!!not�rn writing the responsrble authoriry describing the nature of the disagreement. 77re responsib(e autharrty shal!within 30 days either: (a)correct the data jound fo be inaccurate or incomplete and attempt to notify past recipients ojinaccurate or incomplete data,rncluding recipients named by the individual;or(b)notify the indivrdual that he believes the data to be correct. Data in dispute shal!be disclosed only rf the indivrdual's statement of disagreement is included with the disclosed data. The delermination of the responsibfe authority may be appealed pursuant to the provisions ojthe admrnistrative procedure act relating to contested cases. DATA PRIVACYADVISORY Inaccordahcewith,Lf.S./3.Od,Subd.2,'Rrghtsofsubjectsofdata';wewouldliketornjormyouthatyourrequestforapermitorlicense from the City ojOrono or arry of its departments may reguire you to furnish certain private or confrdential information. You are notifred that: !. The information you1'urnish wil!be used to determrne your qualificatron for!he permit or/icense requested. 2. You may refuse to supply data, but rejusa!may require that the City deny the permit or lrcense. 3. The information may be shared wilh other local,state or federa!agencies ta the extent necessary to process the permit or lrcense. 4. Ijyour requested permit or lrcense requrres Council action to approve,some injormation may become publrc. S. You have certain rights under M.S. 13.04(see jollowing pageJ to revieiv private data on yourself. 6. Your full name is required to process this application or permit. PLEASE PRINT S/�r�� First Middle Last Address Crry State Zip Phone I understand my rrghts as stated ve. Srgnat • !0