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Scc.13.04 RIGHTS OF SLBJGCTS OF DATA Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Infonnation required to be given individual. An individual asked to supply private or confidential data conceming himselY shall be infonned of: (a)the piupose and intended use of the requested data within d�e collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any kno�an consequence arising from his supplying or refusing to supply private or confiden[ial data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision�,to a law enforcement ofFicer. The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax or properri tax refund instructions ins[ead ofon those forms. Subd.3. Access to data by individual. Upon request to a responsible authorig�,an individual shall be infonned whetl�er he is the subjectof stored data on individuals,and whether it is classifled as public,private or contidentiaL Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charee to him and,if he desires,shall be infonned of the content and meaning of dlat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for si� mon[hs thereatter wiless a dispute or action pursuant to this section is pending or additional da[a on the individual has been collected or created. The responsible authoriry shall provide copies ofthe private or public data upon request by the individual suUject ofthe data. The responsib�e authority may require the requesting person to pay the actual costs of making,certifyine,and compiline the copies. Tl1e responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request �vid�in that titne,he shall so inform the individual,and may have an additional tive days�i�itl�in��hich to comply with the request,escludina Saturdays, Sundays and le�al holidays. Subd.4. Procedure�vhen data is not accurate or complete. An individual may conrest the accuracy orcompleteness of public or private data concerning himself. To exercise this right,an individual shall notih in writing the responsible authority describing the nature ofthe disagreement. The responsiblc authority shall within 30 days either. (a)correct the d2ta found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by[he individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The detennination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure ac[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 infonn 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 permit or license requested. 2. You may refuse to supply data,but refusal inay require that the City deny the permit or license. 3. The infonnation may be shared �vith other local, state or federal agencies to the extent necessary to process the pennit or license. 4. [f your requested permit or license requires Council action to approve,some inforn�ation may become ptiblic. 5. You have certain rights under M.S. 13.04(available upon requestj to review private data on yourself. 6. Your full name is rec�uired to process this application or pennit. � � l G�:�� First 1'liddlc LAst l�� l�(�� 7�-��- ��v� ��d �ss /U � � � ,v �/z -�-�S��- Citti' Statc 7ip Phonc I underst d � righ as st�tv�l �hove. / / —__ Signaturc Reset Forni .i'_