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� � - . • Sea 13.04 RIGFTTS OF SLJBJECTS 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 forth in this secaon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial dara concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting 3tate agency,potidcal subdivision,or stacewide sysum; (b)whether he may refuse oY is legally required to suppiy the requested data;(c)aay�own consequence arising from his supplying or refitsing to supply privau or confidential data;and(d)[he idendry of ocher persoas or enrides authorized by state or fedeial law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve data,pursuant to secdon 13.82,subdivision 5,to a law enforcement o�cer. The commissioner of re�enue mav piace the nodce rewired under this subdivision in the individual income tax or propertv taz refund instructions instead of on those foRns. 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 whether it is classified as public,private or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown rhe data wiehout any charge to him and;if he desires,shall be informed of the content and meaning of chat data. Afrer an individuai has been shown the private dara and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acdon pursuant to this secdon is pending or addidonal data on the individual has been collected or created. The responsibie authoriry shall provide copies of the private or public data upon request by the individual subjecc of the data. The responsible authority may require the roquesting person to pay the acrual costs 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 Saturdays,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 addidonai five days within which to comply with the request,exciuding Saturdays, Sundays and legat holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuncy or completeness of public or private data concerning himself. To exercise this right,an individual shall nodfy in wriang the responsible authoriry describing che nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found ro be inaccurnte or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data to be coaect. Data in dispute shall be disclosed only if the individual's statement 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 reladng 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 Ciry 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 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 information may be shared with other local, state or federal agencies to the extent necessary to process the pemut 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. First Middle Last Address � C�ty State Zip Phone I understand my rig as stated above. � \ L� w Signamro