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. • . ' '___� . ... .........'.._._.�..�. .___."'__ ... .!��' �. Sec.13.04 RIGIITS OFSUBJECTS OF'DATA ' ��i ' ;�":,�� Subd. 1. 1`ypc of data- 'C4e rights of individual on whom tho data is scoccd or to bc so�ccd�l�ie�sseZ focd}�fnthis scctioa, 4 � � - . ' � .. ..�JF`.'�. �'L:.�'� :Y >. .,. , Slibd.2. Informatioa requlred to be giren indi�idual. An individual ukcd to suPPtY P.�a or confideadal data coaceming himself shall be info�mcd of: (a)tho puiposc wd intondu!use of the requcsud data within tha collecting state ageucy._poGtial,tubdivisioa.or staLowide rysaem�(b) whether he may refuse or ic kgally rcquued to svpply the requested data;(c)any tnown coauqueuce uising from his supp[ying or re[usiag to suPP1Y pcivax or confidenfial data;and(d)the identity o[other persous or eatiaes autbotized by uate or fcdaca!law�o rcceive the data. This requi�mcnt shall not apply when�n individual is uked oo supply investigative data,pursuant to seetion 13.82,subdivuion 3,to a law enforcemeut officer. 'Ihe commissioner of revenue may�lace the noace Rauiced ander dus mbdivision in the individual income tax or arooertv rez izfund insuvctions inscead of on those fornu. �bd.3. Acc�to data b�hdividual. Upon request�t0 a rospoas9ble authodty,�n individw!shall be info�cd whether he is the subject of soorcd dara on individuals,wd whether it ic classi5ed u public,pcivace or eoafideatial. Upon his further request,an iudividual who is the subjcct of stored Pciva�or pubtie data on individuals shall be shown tho data without�ny eharge to hlm u�d,if he desins,shall be infonmed of the eoatent and mcaning of that data. After an iudividual has been shown the privato data aied infotmed of its meaning.1he da�ta nced aot be d'uclosed to him for aiz moaths dx�ier•unless a dis�{i�or acflon pursuant oo this section'is pending or addiaonal data on the individual has been wAecud or ecuted. The raponsible auchoriry shal!provido copies of the private or pubGc�data upoa rcquest by the individual subjcct of the data. The respoasible authority may nquiro tdc rcquesting person to pay the actual costs of maldng�ccrtifyiug,and wmp�7ing the copies. Tfio`tespo�le wthoriq�shall eomply Immediately,if possible,with any iequest made pursuant oo this subdivuion,or within 6ve days of the dat�of the request,excluding Sawndays,�ays u�d kgal hotidays,if itu.mcdiate complianee is noc possibie: If he cannot comply with We mquest wichin thac pme,he shall so info�m�he iadividual,and may have an iddidonal five days wichin wWch ro comply with the request,excluding Saturdays,Sundays and legal holidays. • . . � . � ' �bd.4, Procedwre whea data is not accurate or eompkta An iudhhilual way'contest the iceuracy or wmpleteness of public or private daa conceming hinuelf. To axerciso t4is right,an individual shall notify in writing.the responsibl4 authoriry descnbing the aahue of the disagreemeaG 'ihe respoas�le au�hodry shall wi�in 30 days eidxr. (a)eoc�ect the data found to be inaccaracc or iacomplete ind�uempt Do aoaty past recipieua of inaccunce or incomplere dara;inefuding rceipieacs named by the individual;or(b)notify the individual that he bclieves the daa to be cornct. Data in disputc shall be disclosed only if tho individual's staecm�nt of disagrccmcat is included with tfie disclosed dara. 'Ihe determination of the responsi'ble autfioriry may be appealed pucsvani Do the provisions of tho adminishative procedure act relating to contestcd cases. DA,'�'A PRI�ACY A.DV�SORY 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 pernut or license from the City of Orono or any of its departments may require you to funaish certain private or confidential information. You are notified that: 1. The infocmation you furnish will be used to determine your qualification for the permit or license requested. 2, You ma}� 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 eztent necessary to process . the per�mit or license. • 4. If your requested permit or license requires Council action to approve, some information may become public. ,; 5. You have.certaim rights under M.S. 13.0� (available upoa request) to review private data on yourself. 6. You full azn is equ' d to process is plication or permit. � � Fint ! O� � '�L /Midd}q _/ , ` Last . �O �o r�f b,�.S/d Addre��, ,t,<.c.v r �� i�it/ �5�� "`�1Sd�—" � �-l�00 Ciry State Zip Phone I underst my rights as tated ve. � . ' na e 10