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.t � . Sec.13.04 RIGH'TS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom[he data is stored or to be stored shall be as set forth in this secaon. Subd.2. Information required to be given individual. r1n individual asked to supply private or confidenual data conceming hicnself shall be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, political subdivision,or statewide system; (b)whether he may refuse oT is legally required to supply the requested data;(c)any k�own consequence arising fmm his supplying or refusing to supply private or confidenriai data;and(d)the identiry of other persons or enrities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to suppiy invesrieadve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re�enue mav piace the noace reauired under this subdivision in the individual income tax or properry tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon requesc 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 request,an individual who is the subject of stored private or pubiic data on individuals shall be shown the data wi�hout any charge to hirn and,-if he desires, shall be informed of the contenc and meaning of[hat data. Afrzr an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acaon pursuan[to this secaon is pending or addidonal data on the individual 6as been collected or created. The responsibie 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 requesting person to pay the actual costs of making, cerdfying,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 date of the request,excluding 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 addidonal five days within which to comply wich the request,excluding Saturdays, Sundays and lega(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 norify in wridng the responsible authoriry describing[he nature of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of inaccurate or incomplete data, including recipients named by the individual; or(b)nodfy the individual that he believes the data to be correcc. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the tesponsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�hhts of subjects of data", we would like to inform you that your request for a pemut or license from the City 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 deternune your qualification for the pemut or license requested. 2. You may refuse to supply data, but refusal may require Ihat 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 Councii action to approve, some information may become pubiic. 5. You have cenain 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. First Middle Last Address C�ty State Zip Phone I understand my rights as stated above. , •_ _ �— �1 � _ c_ nature