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Sec.13.04 RIGHTSOFSUBJECTSOFDATA Subdivision 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in thrs section. Subd.2. Injormation required[o be given individuaL An individual asked to supply private or confrdential data concerning himself shal!be injormed of (aJ the purpose and intended use of the requested data withrn the collecting state agency,political subdrvrsion,or statewide system;(b)whether he may refuse or is legally required to supply the requested data;(c)any knotivn consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity ojother persons or entities authorized by state or federa!Imv to receive lhe data. This requirement shall not apply when an individua!is asked to supply investigative data,pursuant to section 13.82, subdrvision S, to a law enjorcement o�cer. The commissioner afrevenue mav place the notrce required under[his subdrvrsion in the individual income tax or property tax reJ'und instructions instead ofon those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an indrvrdual shall be informed whether he rs the subject ojstored data on indrvrduals, and whether i1 is classifred as public,private or confrdentral. Upon hrs jurther request,an individual who is 1he subject ofstored private or public data on indivrduals sha11 be sho�vn the data ivithout any charge to hrm and, rf he desrres,shall be informed of the content and meaning of that data. Af1er an indrvidual has been shotivn the prrvare data and informed ojits meaning, the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to thrs sectron is pending or additrona!data on the individual has been collected or created. The responsible authoriry shall provrde copres of the private or public data upon request by the rndrvidual subject of the data. The responsible authority may require the requestrng person to pay�he actual costs oJmakrng,cert�ing,and compiling the copres. The responsible authority shall comp/y immediately,ifpossible,with any request made pursuant to this subdivision,or within fve days of the date ojthe xeqtiest,excluding Saturdays,Sundays and legal holidays,if immedrate compliance is not possible. If he cannot comply tivith the request within that time,he shal!so injorm the individual,and may have an additional frve days within which to comply with the request,excluding Saturdays,Sundays and legal holidays. Subd 4. Procedure when data is not accurate or complete.An indrvidual may contest the accuracy or completeness ofpublic or private data concerning himself. To exercrse lhis right, an individual shall not�in writing the responsible authoriry describing the nature of the disagreemen�. The responsible authority shal!within 30 days either: (a)correct the datafound lo be inaccurate or incomplete and attempl to not� past recipients of inaccurate or rncomp/ete data,including recrpients named by the individual;or(bJ notify the indrvidua!that he believes the data to be correct. Dala in dispute sha!!be disclosed only ijthe indrvidua!'s statement ojdisagreement is included with the disclosed data. The determrnation af the responsrble authoriry may be appealed pursuant to the provisions of rhe admrnistrative procedure act relating to contested cases. ' � • DATA PRIVACYADVISORY In accordance with MS.13.04,Subd.2, "Rights ofsubjects ojdata",we tis�ould like to inform you that yourrequest for a pei mit or license from the City ojOrono or any of its departments may regulre you to furnish cerlain private or confidential information. You are notrfred that: , • , . 1. The information you furnish will be used to determine your qualificalion for the permit or lrcense requested. 2. You may refuse to supply data,but refusa!may require that the Ciry deny the permit or license. 3. The injormalron may be shared with other local,state or federa!agencres to the exlent necessary to process the permit or license. 4. IJyour requesled permi!or license requires Council action to approve,sorne information may become pubGc. 5. You have cerlarn rights under M.S. 1 j.04(see following pageJ to revie}v private data on yourself. 6. Your ful!name is required to process this applieation or permit. PLEASE PRINT �v�. � , ��,: I�� ,� ' Frrst Middle L st �YLxt /1�7'7�I�- (�WQ Address �-. 3�% C�i 2-��' �ry State Zip Phone n e ta righls as stated above. rgnalure 10