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r Sec.13.04 RIGHTS OF S[JBdECTS OF DATA Subd. 1. Type of data. The rights of individual on whom rhe data is stored or to be stored shall be as set focth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the puipose and intended use of the requesred data within the collecting�tate agency,political subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the idenriry of other per�ons or enriries authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve data,punuant to secdon 13.82,subdivision 5,to a law enforcement officer. The commissioner of re�enue mav place the nodce required under this subdivision in the individual income tax or provertv taz refund instrucdons inscead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individua(shali be informed whether he is the subject of stored data on individuals,and whecher it is classified as public,private or confidential. Upon his f»rther request,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 d'uclosed to him for six months thereafter unless a dispute or acdon pursuant to this secrion is pending or addidonal data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesdng person to pay the acrual 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 the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shal(so inform the individual,and may have an addidonal five days within wluch 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 compleceness of public or private data concerning himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing che nature of the disagreement. The responsible authority shail within 30 days either: (a)correct[he data found to be inaccurate or incomplete and attempt to nodfy past recipienu of inaccurate or incompiete data, including recipients named by che individual;or(b)notify the individual that he believes the data to be correct. Dara in dispute shall be disclosed oniy if the individual's statement of disagreement is included with the disclosed data. The decerminadon of the responsible authority may be appealed pursuant to the provisions of the administradve 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 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 permit or license. 3, The information may be shared with other local, state or federal agencies to the eztent 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, Your full name is required to process this application or permit. Fi�� Middle Last Address � Ciry State Zip Phone I understand my rights as stated above. Signaturo