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, � Sec13.04 RIGHTS OF SIBJECTS OF DATA Subd. l. Type of da[a. 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[o be given individual. An individual asked to supply private or confidential data concerning himselY shall be infonned of: (a)the purpose and intcnded use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive che data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a la�v enforcement ofticer. The commissioner of revenue ma�place the notice re4iired under this subdivision in the individual income tax or prooerty tax refund instructions instead of on those fonns. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned��-hether he is the subject of stored data on individuals,and��hether it is classitied as public,private or confidential. Upon his further request,an individual who is the subject of stored private or pubGc da[a on individuals shal I be shown the data without any charge to him and,if he desires,shall be infonned of the content and meaning of that data. Afrer 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 action pursuant to this section is pending or additional data on Uie 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 of making,certit�-ing,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or�vithin five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compl iance is not possible. If he cannot comply with the request within diat time,he shall so infonn the individual,and may have an additional tive 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 individual may mntest the accuracy or completeness of pubtic or private data concerning himsel£ To e�ercise this right,an individual shall notify in��i[ing the responsible authority describing the nature ofthe disagreement. The responsible auihority shall within 30 days either. (a)correct the data tiound to be inaccurate or incomplete and attempt to��otify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispuce shall be disclosed only if the individual's scatement of disagreement is induded with the discicsed data. The determination ofthe responsible authoriq�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",we would like to inform you that your request for a pennit or license from the City of Orono or any of its departments rnay require you to furnish certain private or confidential information. You are notified that: 1. The infonnation you furnish will be used to detennine your qualification for the permit 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 extent necessary to process the pennit or license. 4. If your rec�uested permit or license requires Council action to approve, some information may become public. �. 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. ��M�"s �D��1/ Nvss�"2 � First Ntiddle Last o�� 1��Jr.t� �f}�1(� 5, .4ddress �� _ ��_�� City StAte 'Lip Phone 1 unders d y rights as stated ab S'e ature ��