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� Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The righcs of individual on whom[be data is scored or to be stored shall be as set forth in this secdon. Subd.2. Information reqtrired to be�ven individual. An individual asked to supply private or confidendal data conceming himself shall be informed of: (a)the purpose and in[ended use of the requesud data within the collecdng'state ageocy, political subdivision,or statewide rystem; (b)whecher he may refuse or is legally required to supply the reques[ed data;(c)any lmown consequence arising from his supplying or refusing to supply • private or confidendal data;and(d)the idenriry of ocher persons or enddes auchorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesoeadve data, pursuanc to secdon 13.82, subdivision 5, to a law enforcement officer. - The commissioner of revenue mav place the noace reouired under this subdivision in the ind�vidual income tax or propertv tax refund instrucrions inscead of on those forms. Subd. 3. Access to data by individual. Upon reques[to a responsible au[horiry,an individual shall be informed whether he is the subject of scored data on individuals, and whe[her ic is classified as public, private or confidenaal. Upon his fur[her request, an individual who is the subjecc of stored private or public daca on individuals shall be shown che data wichouc any charge to him and, if he desires, shall be informed of the content and meaning of chat data. Afrer an individual has been shown[he privace data and informed of its meaning,the data need no[be disclosed[o him for six months thereafter unless a dispute or acrion pursuanc to chis secdon is pending or addidonal data on[he individual has been collected or creaced. The responsible authoriry shall provide copies of the private or public data upon requesc by the individual subject of the dara. The responsible authoriry may require[he requesting person to pay the actual costs of making, cerafying,and compiling the copies. The responsible authoriry shall comply immedia�ely, if possible, with any request made pursuant to rhis subdivision, or within five days of the date of the requesc,exciuding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that tirne,he shall so inform[he tndividual,and may have an addiaonal five days wichin which to comply wich the request,exciuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise chis right,an individual shall norify in wricing the responsible auchoriry describing the nacure of the disagreemeac. The responsible authoriry shall within 30 days either: (a)correcc the data found to be inaccurate or incomple[e and attempt to nodfy pasc recipienu of inaccurate or incomplete data, induding recipiencs named by che individual; or(b)noufy[he individual that he believes rhe data to be correct. Data in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. The determinarion of the responsible authoriry may be appealed pursuanc to the provisions of che adaunisaarive procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�hts 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 permit or license requested. 2. You may refuse to supply data, but refusai 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 permit or license. 4. If your requested pernut or license requires Council action to approve, some information may become public. 5. You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your fuH name is required to process this applicacion or permit. � �� Firsc �tiddle Lasc Address Ciry State Zip Phone I understand my ri�ht as tated above. � a . �-. . Signacure