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•�--^ � Sec.13.04 RIGHTS OF St�BJECTS OF DATA Subd.1. Type of data. T6e rights of indi�3dua1 on whom the dars La stored or to be stored shali be as set forth in this sectiom Subd.2. I�formadon required to be given individual. An indi�idaal asked w supply private or confidenUal data concerning himselis6all be informed of: (a)the purpose and intended use of the requested data wit6ia t6e collecbng state agency,political subdivision,or statewide system;(b) whether 6e may refuse or is legally required to supply the requested data;(c)iny known rn�sequence arising from his supplying or refusing to supply private or rnnRdenttal dau;and(d)the identity ot other persons or enHties aathorized by state or federal law to receive the data.This reqairement shall not apply when an indicidual is asked to supply investigative data,pursuant w section 13.82,subdivision 5,to a law enforcement ofFcer. The commissiooer of revenue ma lace the notice r uired onder this subdivisioo in the(ndividual income tax or ro ertv tax refund instruMions instead of on those Corms. Subd.3. Access to data by individual. Upon request to a respoas3le authority,aa individual shall be iaformed whet6er he is the subject of stored data on individuals,znd whether it Is classified as public,private or eonfidential. Upon his further request,an Individual who Ls the subject of stored private or publ(c data on individuals shall be s6own the data wit6oat any charge to hlm and,if 6e desires,shall be Informed 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 disciosed W him for six months thereafter unless a dispute or action pursuant W this sectlon is peufiing or additional data on the individual 6as been coUected or created. The responslble authority shall provide rnpies of t6e private or public data upon request by the Individual subject of the data. T6e responsibie authortty may require the requesting person to pay the actual costs of making,certifying.and rnmpiling the copfes. The responsible authority shall comply immediately,if possible,RitL any request made pursuant to t6is subdlvision,or wlthin frve days of the date of the request,excluding Saturdays,Sundays and le;al holidays,(f immediate compllance is oot possibie.If he cannot rnmply with the request within that time,he shail so inform the individual,and may har-e an additiooal five da�s within which to comply with the request,excluding Saturdays,Sundays and legal holidays. Subd.4. Procedare when data is not accurate or complete.An indis-idual may contest t6e accuracy or completeness of public or private data concerning himself. To ezercise this right,an lndividual shall notify in writing the responsible suthority describing the nature of the disagreement. The responsible suthority shall within 30 days elther: (a)correct the data found W be inaccurate or Incomplete and attempt to notify past recipients ot Inaccurate or incomplete data,including recipients named by t6e individual;or(b)nodfy the individual that he bel�eves the data to be correct. Data in dispute shall be disclosed onty if the indlvidual's statement of disagreement is included with the disclosed data. T6e determination of the responsible authority may be appealed parsuant to the provisions of the administrative procedure act relating to contested cases. D�TA PRIVAC�AD�TSORY In accordance�ith l�I.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that�our 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 cour qualification for the permit or license requested. 2. You ma�-refuse to supply data,but refusal ma�require that the City deny the permit or license. 3. The information may be shared with other locaL,state or federal agencies to the eztent necessan to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You ha��e certain rights under�I.S.13.04(a��ailable upon request)to review private data on�oursetf. 6. Your full name is required to process this application or permit. ��( � I�OO�S First �fiddle Last Address C�ty Stau Z�P Phone I understand my rights as stated above. r---- ' � Slgnature