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� � � Sec.13.04 RIGHTS OF SUB.TECTS OF DATA Subd. 1. Type of data. The rights of individual on whom[he data is stored or co be stored shall be as set fonh in this secdon. Subd.2. Information reqirired to be given individual. r1n individual asked to supply priva[e or confidendal data concerning himse(f shall be informed of: (a)the purpose and intended use of the requested data within the collecting'sta[e agency, polidcal subdivision,or statewide system; (b)whether he may refuse or is legally required to supply the requested data;(C)any Irnown coasequence arising from his supplying or refusing to supply • private or confidendal data;and(d)the idennty of other persot�s oC enddes authorized by state or fedecal law to receive the data. This requirement shall not apply when an individual is asked to supply investieadve data, pursuanc to secaon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re�enue mav place the norice reauired under this subdivision in the individual income tax or propertv tax refund instrucaons ins�zad of on chose forms. Subd. 3. Access to data by individual. Upon request to a responsible aurhoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public, privace or confidenaal. Upon his further request, an individual who is the subjecc of stored private or public data on individuals shall be shown the data wichout any charge to hun and, if he desires, shall be informed of the content and meaning of that data. Afrer 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 action pursuant[o this section is pending or addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the priva[e or public data upon request by the individual subject of the data. The responsible authority may require the requesting person ro pay the 3ctual costs of making, certifying,and compiling the copies. The responsible authority shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the date of[he request,exc(uding 3aturdays,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,and may have an additionai 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 concerning himself. To exercise this rieht,an individual shall norify in wridng the responsible authoriry describing the nature of the disagreement. The responsible authority shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attemp[to nodfy past recipiencs of inaccunte 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 de[ermination of the responsible authoriry may be appealed pursuant ro the provisions of the administnrive procedure act reladng to contesred 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 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 pemut or license. 3. The informaYion may be shared with other local, state or federal age�ies 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 pubiic. j. 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 �fiddle Lasc A�9� ��.��`�a� � 14a — Address ��-�aN �I�` �'�l2 I L�� ' ��70 Ciry Stata Zip Phone I understand my ghts as tated abo . Signa[ure