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5ec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights oti individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private orcontidential data concerning himselfshall be infonned of: (a)the purpose and intended use of the requested data�vithin the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legal ly required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply privare or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shal I not apply when an individual is asked to supply investigative data,pursuant ro section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue ma�lace the notice required under this subdivision in the individual income tax or propertv tax refund instructions instead of on those tonns. 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 whedier it is classitied as public,private or contidentiaL Upon his fuRher request,an individual who is the subject of stored private or public data on individua(s shall be shown the data without any charge to him and,if he desires,shall be informed of dte content and meaning of that data. After an individual has been shown the private data and infonned of its meaning,the data need not be disclosed to him for si� months thereafter unless a dispute or ac[ion pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority 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 oY making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of the date of the request,e�cluding Saturdays,Sw�days and legal holidays,if immediate compliance is not possible. If he cannot comply 4vith the request within[hat time,he shall so inform die individual,and may have an additional tive days within which to comply with the request,e�cluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the aceuracy or completeness of public or private data concerning himself. To exercise this ri�ht,an individual shafl notify in writing the responsible autliority describing the nature of die disagreement. The responsible au[hority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notift�past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notiF}the individual that he believes the data to be correcc Data in ri�SFi,�rr gl��ll�P rlicclnsed only if tl�e individual's sratement of disagreement is induded with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the adminisvative procedure act relating to contested cases. DATA PRIVACY ADVISORY 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 permit 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 determine your qualification for the perniit or license requested. 2. You may 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 estent necessary to process the pern�it or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or pennit. First N[iddle Last .4ddress Cih� State Zip Phone I u 1 ersta my rig ts as stated above. J' .�� Signature Reset Form .?�