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A .` Sec.13.04 RIGH'TS OF SUB.TECTS OF D�TA Subd. 1. Type of daca. The righcs of individual on whom[he data is stored or[o be stored shalI be as set focth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply privace or confidendal data concerning himself shail be informed of: (a)the purpose and intended use of the requesied dara within the collecang�tate agency,polidcal subdivision,or sratewide sysum; (b)whether he may refuse oY is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing to supply private or confidenaal data;and(d)the idendry 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 invesdgadve data, pursuan[to secuon 13.82, subdivision 5, to a faw enforcement officer. The commissioner of revenue mav place the noace reauimd under this subdivision in the individual income tax or oropertv tax refund instructions instead of on those forms. Subd. 3. Access to data by indi��dual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and wherher it is classified as public, privace or confidendal. Upon his further requesc,an individual who is the subject of stored private or public data 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. Afczr an individual has been shown che private data and informed of its meaning,the data need not be disclosed to him for six monchs thereafter unless a dispute or action pursuanc to [his seccion is p�nding or addiaonal data on the individual has been collected or creaced. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the actual costs of making,cerafying,and compiling the copies. The responsible authoriry shall comply immediatety, if possible, with any request made pursuant co this subdivision,or within five days of the date of the requesc,exctuding Sacurdays,Sundays and legal holidays,if immediace compliance is not possib(e. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addirional five days within which to comply with the requesc,exc!Lding Saturdays, 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 dara concerning himself. To exer�ise this right,an individuai shall norify in wrian,the responsible authority describing[he nacure of the disagreement. The responsible auchoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and aaemp[to nodfy past recipienu of inaccurate or incomplete data, inciuding recipiencs named by [he individual;,or(b)notify the individual tha[he believes the data to be correct. Data in dispu�e shali be disclosed only if the individual's sta[emen[of disa;reement is included with the disclosed data. Tlie decerminarion of che respcnsible authoriry may be appealed pursuant to the provisions of the admuusaarive procedure act reladng to con[ested 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 permit or license from the Ciry 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 permit or license requested. 2. You may refuse to suppiy data, but refusal may require that the City deny the pemut 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 pemut or license requires Council action to approve, some information may become public. 5. You have cenain rights under Ni.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 �fiddle Last Address C�ry, State Zip Phone I understand my rights as stated above. �� S �� Signature