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� s � Sec.13.04 RIGATS OF SUBJECTS OF DATA a Subd. 1. Type oY data. The rights of individual on whom the data is stored or to be stored st�all be as set forth ia this section. Subd.2. Information requdred to be given individual. An i�ividual asked to supply private or confidential data concerning himself shall be informed of: (a)the putpose and inte�led 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 dara;(c)aay Irnown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the iden6ry of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to suppiy invesdgative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav olace ihe rodce reauired under this subdivision in the individual u�come taz or oronertv tax refund instructions instead of on those forms. Subd.3. Access to data by individaal. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of swred private or public data on individuals shaq be shown the data without any charge to 6im and,if he 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 disclosed to him for six months thereafter unless a dispute or acdon pursvant ro this secaon is peirling or addirional 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 audioriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. The responsible aud�oriry shall wmply immediately,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 icnmediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addidonal five 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 contest the accuracy or completeness of public or private data co�eming himself. To ezercise this right,an individual shall nodfy in writing the responsible authoriry describing the namre of the disagreemetu. The responsible auttwriry shall within 30 days either. (a)correct ihe data fouid to be inaccurate or incomplete and atiempt to notify past recipients of inaccurate or i�omplete dara,i�luding recipients named by the individual;or(b)notify the individual that he believes the data to be conect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with rhe disclosed data. The determinadon of the responsble authoriry 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 permit or license from the�iry 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 refusal may require that the City deny the permit or license. 3. The information may be shazed 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. Y full name is required to process this application or permit. First iddle 3�� Addres ---- !.� S� �- -8"z � Ciry State Zip Phone I understand m sta d above. Signature ~ 6