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Sec.13.04 RiGHTS OF SUBJECTS OF DATA � Subd. 1. Type of data. The rights of individual on whom the data is stored or to Ue stored shall Ue as set forth in this section. � Subd.2. Infonnation required to Ue given individual. An individual asked to supplyprivate or confidential data concernin;himselfshall be informed of: (a)the pucpose and intended use oF the requested data within the collecting state agency,political suUdivision,or statewide system;(b) whether he may refuse or is legaily required to supply the requested data;(c)any kno�m consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement sliall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or oropercv tax refund instructions instead of on those fortns. Su6d.3. Access[o data Uy individuai. Upon request to a responsiUle authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classitied as public,private or confidential. Upon his furtl�er reques[,an individual wl�o is the subject of stored private or public data on individuals shall be sho�vn the data witl�out any charge to him and,if he desires,shall be infortned of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereat�er unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs oti making,certifying,and compiling the copies. Tlte responsible authority shall comply immediately,if possiUle,with any request made pursuant to this subdivision,or within five days ofthe 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 infortn the individuai,and may have an additional tive days within wllich to comply with the request,excluding Saturdays, Sundays and legal holidays. . SuUd.4. Procedure when data is not accurate or comple[e. An individual may contest the accuracy or completeness of public or private daca conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either. (a)coirect the data foiuid to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipien[s named by the individual;or(U)notify the individual that he believes the data to be wirect. Data in dispute shall be disclosed only if d�e individual's statement of disagreement is included with che disclosed data. The detertnination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",�ve would like to inform you fliat your request for a permit or license from the City of Orono or any of its departments inay require you to furnish certain private or confidential infotmation. You are notified that: 1. The infom�ation you fiirnish will be used to deternune your qualification for the permit or license requested. 2. You may refuse to supply data,but refusal may requu�e 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 permit or license. 4. If your requested pemut 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 permit. First Middle Last Address City State Zip Phonc I understand my rights as stated ve. � � ignature ' 10