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. �. . � Sec.13.04 RIGHTS OF SLJBJECTS OF D�T?� Subd. 1. Type of data. The righcs of individual on whom[he da[a is stored or to be scored shall be as set fonh in this secrion. Subd.2. Information reqirired to be givea individual. ?�n individual asked to supply private or confidendal data conceming himself shall ba informed of: (a)the purpose and inrended use of che requated data wichin the collecdng�tate agency,polidcal subdivision,or sracewide rysum; (b)whecher he may refuse oY is kgally required to supply the cequestcd data;(c)any lrnown consequence arising from his supplying or refusing to supply • priva[e or confidendal data;and(d)[he idendry of o�her persoas or enriaes auchorized by srate or federal law to receive[he data. This requirement shall not apply when an individual is asked[o supply invcsdgadve dara,pursuant to section 13.82,subdivision 5, to a taw enforeement o�cer. - The commissioner of revenue mav place the notice rauired under this subdivision in the individual income rax or propertv tax refund inscrucrions instead of on�hose forms. Subd.3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject of scored dara on individuals,and whecher ic is ciassified as public,privace or confidendal. Upon his fur[her request,aa individual who is the subjec� of stored private or pub(ic dara on individuals shall be shown che da[a wichouc any charge to him and;if he desires, shall be informed of the coatenc and meaning of chat data. Aher an individual has been shown�he privace dara and informed of ics meaning,che dara need not be disclosed to tum for six monchs thereattec unless a dispute or acaon pursuanc to chis secaon is panding oc addiaonal dara on[he individual has been collecced or crea[ed. The responsible authoriry shall provide copies of the private or public data upon request by the individual subjecc of the daca. The responsible authoriry may require[he requesting person to pay the acmai coscs of making,cerdfying,and compiling the copies. The responsible authoriry shall comply immediatety,if possible,with any requesc mada pursuant to rhis subdivision,or wi[hin five days of tha date of[he requesc,exctuding Saeurdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within chat time,he shall so infocm[he individual,and may have an addidonal five days wi[hin which to comply with the request,excluding Saturdays, Sundays and legai holidays. Subd.4. Procedure when data is not accurate or complete. An individual may concest the accuracy or completeness of public or private dara concerning himself. To exercise chis righc,an individual shali noafy in wridng che responsibie au[horiry describing rhe nacure of rhe disagreemenc. The responsibie authoriry shall within 30 days either: (a)correcc[he da[a found to be inaccurate or incomplete and attempc to nodfy past recipienrs of inaccurate or incomplete dara,including recipiencs named by the individual;or(b)notify ehe individual that he betieves che dara co be correc� Data in dispute shalt be disclosed only if ihe individual's sracemenc of disagreement is included with the disclosed dara. The decerminarion of the responsible au�horiry may be appealed pursuant to the provisions of ct►e adminisaarive procedure act reladng to contesced cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�hts of subjeccs of data", we would like to inform you that your request for a pemut or license from the Ciry of Orono or any of its departments may require you to fumish 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 co supply data, buc 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 excent necessary to proeess the permi[ or license. 4. If your requested permit or license requues 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. First �tiddle Lasc Address • Ciry State Zip Phoae I underst y rights as stated ov � Signamre