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� � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be sto�ed shall be as set forth in this secaon. Subd.2. Information req�rired to be givm individual. An individual asked w supply private or confideadal data concerning himself shall be informed of: (a)the pucpose and intended use of the rsqnesred dara within the collecting Ytate agency,policcal subdivision,or stacewide sysum; (b)whether he may refuse oY is legaliy required to supply the cequesud dara;(c)any Irnown consequence arising from his supplying or refusing w supply privace or confidential data;and(d)the idenary of other persoas or endaes au[horized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigadve data,pursuaat m section 13.82,subdivision 5,to a law enfoccement officer. The commissioner of revenue mav olace the norice rewired under this subdivision in the individual income tax or proaem taz refund instructions inscead of on those forms. Subd.3. Access to data by individual. Upon request to a msponsible authoriry,an individual shall be informed whether he is the subject of stored data on individuats,and whe[her it is classified as public,private or con6denaal. Upon his further request,an individual who is the subject of stored privau or public data on individuals shall be s6own the dara wirhout any charge to him and,-if he desires,shall be informed of the content and meaning of[hat data. After an individual has been shown the ptivate dara and informed of its meaning,the data need not be disclosed to him for six months thereafur unless a dispute or action pursuanc to[his secdon is pending or addidonai data on the individual has been collecud or created. The responsible authority shali provide copies of the private or public data apon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. The responsible authoriry shall comply 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 immediace 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 compiy with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accurecy or completeness of public or private data concerning himself. To exercix this right,an individual shall nodfy in wri[ing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incompleu and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by die individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispute shali be disclosed only if ehe individual's stamment of disagreemenc is included with[he disclosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administradve proceduro act relating to contesud 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 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 detemune your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the Ciry 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. (, Your full name is required to process this application or permit. First Middle Last Address • Ciry State Zip Phone I understand my rights as stated above. Signaare