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� Sec.13.04 RIGHTS OF S[TBdECTS OF DATA Subd. 1. Type of data. The righ[s of individual on whom[he data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information req�rired to be given individual. An iadividual asked to supply private or confidential data concerning himself shall be informed of: (a)the pucpose and intended use of the requested data widiin the collecting State agency,political subdivision,or stauwide system; (b)whether he may refuse oY is legally required to supply the requested data:(c)any lmown coasequence arising from his supplying or refusing w supply private or confidential dara;and(d)the idenrity of othet persons or endties authorized by state or federel law to receive the data. T7�is requirement shall not apply when an individual is asked to supply invesdgadve data,pursuant m section 13.82,subdivision 5,to a law enforcement officer. The commissioner of rovenue mav alace the notice nwired under this subdivision in the individual income tax or vmaortv taz refund instiucaons instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whe[her it is classified as public,private or con6dential. Upon his further request,an individual who is the subject of stored privau or public data on iadividuals shall be shown the data without aay charge to him and;if he desires,shall be iaformed of the content and mr n��g of that data. Afur an individual has been shown the private data and informed of iu meaaing,the data need not be disclosed to him for siz months thereafur unless a dispute or action pursuanc to this secdon is pending or addidonal data on the individual 6as been collected or creaud. The responsible suthority shall ptovide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual cosu of making,cerdfying,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 Saa�days,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 addirional five days within which w comply with the request,ezcluding 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 right,an individual shail noafy in writing the responsible suthoriry describing the nature of the disagnement. The nsponsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompleu and atumpt to noafy past recipients of inaccurate or incomplete data,iacluding recipients named by the individual;or(b)notify the individual that he believes the data to be correct Data in dispute shall be disclosed only if the individual's stacement of disagreement is included with the disclosed data. The determinadon of the responsible authority may be appealed pursuant to the provisions of the administradve procedure act relating w conusted 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 fumish 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 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 may become public. $, 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. 1`-1�eu 5,77�rv`e--. � �Q-,p � First Middle �� Ad S� � �j � � City State Zip Phone I understand my rights stat d ve. Signature