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Sec.13.04 RIGHTS OF SUBJECTS OF DATA " Subd. 1. Type of data. The rights of individual on whom[he data is stored or to be stored shall be as set forth in this sec[ion. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended 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 reques[ed data;(c)any known consequence arising from his supplying or refusing to supply private or conEidential data;and(d)the identity of other persons or entities au[horized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to secaon 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav olace the notice rea�ired under this subdivision in the individual income tax or orooertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is[he subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further rcquest,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 that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed[o him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shalt provide copies of the private or puUlic data upon request by the individual subject of the daca. T'he responsible authoriry may requirc[he requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authori[y shall comply immediately,if possible,with any request made pursuant to this subdivision,or wi[hin five days oFthe date of the request,excluding Sa[urdays,Sundays and legal holidays,if immediate compliance is not possible. If he canno[comply with[he request within that time,he shall so inform[he individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accura[e or complece. An individual may con[est the accuracy or completeness of public or private data conceming himself. To exercise this right,an individual shall notify in writing che 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 incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)no[iFy the individual that he be(ieves the data to be coRect. Data in dispute shall be disclosed only iF the individual's statemeat of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions oF the administrative procedure act relating co contested cases. DATA PRIVACY ADVISORY 4 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 determine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusal may rec�uire 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 rnay 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 Middle Last S� i�t��.= �� 1-C`��,� Address City State Zip Phone I under d my ri as stated above. , � �� Si ature 1�