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« � Sec.13.04 RIGHTS OF SUB.TECTS OF DaTA Subd. 1. Type of data. The righrs of individual on whom[he data is s[ored or to be stored shall be as set forth in this secrion. Subd.2. Information reqtrired to be given indiridual. An individua]asked to supply private or confidenrial dara concerning himself shall be informed of: (a)the purpose and intended use of the requested dara within the collecang'state agency, polidcal subdivision,or sratewide system; (b)whether he may refuse or is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing[o suppty private or confidential data;and(d)the identiry of other persons or enrides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdeaave dara, pursuan�co secaon 13.82, subdivision 5, to a law enforcemen[ofFicer. The commissioner of re�enue mav place the notice reauired under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request 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, privace or confidendai. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the dara wirhout any charge to him and, if he desires, shall be informed of the content and meaning of chat data. Afrer an individual has been shown the privace data and informed of its meaning,the data need not be disclosed to hun for six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addiaonal data on the individual has been collected or crea[ed. The responsible authoriry shall provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authoriry may require [he requesring person to pay the actual cosu of makine, cerafying, and compiling the copies. The responsible authoriry shall compiy immediately, if possible, wi[h any request made pursuant to this subdivision,or within five days of the date of the request,ezcluding Sacurdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot comply with the request wichin that time,he shall so inform the individual,and may have an addirio�al five days wi[hin which to comply with the request,excluding 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 data concerning himself. To exercise this right,an individual shall noafy in wricing the responsible authoriry describing the nature of the disagreement. The responsibte authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomp(ete 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 ro be correct. Data in dispute shall be disclosed only if the individuai's statement of disagreement is included with the disc(osed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng ro contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Riohts 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 furnish certain private or confidential informa[ion. You are notified that: 1, The information you furnish wiil be used to determine your qualification for the permit or license requested. 2. You may refuse [o 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 permit or license requires Council action to approve, some informa[ion may become public. 5, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. (, Your full name is required to process this application or permit. , ` �� ,y��..� � � 1'`� � `�` (� V � First _,_ �id�z Last � � � � �..� ✓��-ti�53� ��—i/y-� - Addrea� � �' V'�-'�V i�/ �-� - Ciry Sta�e ZiP Phone I understand my rights as Stated b ve. Signa[ure