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, _ _. � _� T Sec.13.04 RIGATS OF SUBTECTS OF DATA Subd. 1. 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. Informatton reqirired to be given individual. An individual asked to supply privatc or confidential data co�eming himself shall be informed of: (a)the purpose aad intended use of the requested data within the collecting state agency,polidcal subdivision,or stauwide system;(b)whether he may refuse or is legatly required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing ro suppty private or confidential data;and(d)the identity of other persons or entides authorized by state or federal law to receive the data. This requirement shall not apply when an indiyidual is asked to supply inves6gauve data, pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. The cocnmissioner of reverwe mav olace the nodce rewired under this subdivision in the individual income tax or orocertv taz refund instrucrions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authority,an iadividual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon 6is further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and meaning of rhat data. After an individual t�as been shown the private data and informed of its meaning,the data need not be disclosed to him for six months d�ereafter unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public dara upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. , The responsible authority shall comply immediatety,if possible,with any request made pursuant to this subdivision,or within five days of the 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 inform the individual,aixi may have an addiaonal five days within which to comply with the request, exduding 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 conceming himself. To ezercise this right,an individual shall nodfy in writing the responsible authority describing the nature of the disagreement. T6e responsible authoriry shall within 30 days either: (a)correct the data found ro be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)nodfy 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 determination of the responsible authoriry may be appealed pursuant to the provisions of the administradve 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 permit or license from the�ity of Orono or any of its departments may require you to fumish certain private or conf'idential information. You aze notified that: 1. The information you fumish will be used to determine 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 permit or license. 4. If your requested permit 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. �c-��,,r. `��v 1� �M�ddle � ,^� Last V ' d ss , 1L :,�, � ��N �� l � �-� ��S ry State Zip Phone I understand my rights as stated abov � � Si 6