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i � Sec.13.04 RIGHTS OF S[JB.TEC'TS OF DATA Subd. 1. Type o[data. The righes of individual on whom che data u stored or w be stored shall be u set focth in rhis secdon. Subd.2. InPormation req�red to be=irw individual. An individual asked w supp�Y private or confidendal data conceraing himself shall be info�of: (a)the puipose and inrended use of the requested data within t6e collecang itate agency,political subdivision,or sncewide ryscem; (b)whettter he may csfuse ot is legatly tequired to supply the requesoed data;(c)anY latown coauquence arising from his supplying or refusing to suPP�Y priva[e or confidendal data;and(d)che idenriry of other persoos or enaaes authorized by state or federal law to receive the data. 'Ilsis requiremcnt shall not apply when an individual is asked to supply invesrigadve dan,punvanc to secdon 13.82,subdivision S,to a law enforcement ofFcer. The commissioner of re�enue mav vlace the nocce �ewired under chis subdivision in the individual income tax or orooem taa rofund instmctions ins[ead of on those foRns. � ! ,,�.� . . Subd. 3. Accas to data by iadividual. Upon nquesc to a rcsponsible authoriry,an individual shall be informed whether he is the subject of stond data on individuals,and whether it is class�ed as public,private or confi�ential. Upon his fu�ther request,an individual who is the subjecc of stored private or public data on individuals shall be shown che data wirt►out aay charge W him and,'if he desires, shall be informed of the coatent and meaning of chat data. Afur an individual has been shown ehe private data and informed of irs meaniag,the data need not be disclosed to him for six monchs thereafur unless a dispute or acaon pursuane to ehis secaon is pending or addidonal data on the iadividual has beea wllected or crcaced. The responsible auihoriry shall provide copies of the private or pubtic data upon requesc by the individual subject of che data. The nsponsible authoriry may requin ehe roquesting person to pay the acaal costs of rnalcing,cerdfyiaS.u�compiling t�e coPies. , The responsible authoriry shall comply immediately,if possible,wi�h any requeft made pu�suant to this subdivision,or wichin five days of the date of the request,excluding Sawrdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannoc comply with the requesc wi[hin that time,he shall so inform d►e individual,and may have an addidoaal five days wid►in which w comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procednre v►hen data Ls not accurate or complete. M individual maY contest the accuracy or completeness of public or pm•ate data conceming himself. To exercise chis righ4 an individual shaU nodfy in writiaQ che nsponsible suthority describing�t►e naare of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the"data found to be inaccucate or ixomplete and saempt W nodfy past recipienu of inaccurate or incomplete data, including recipients named by ehe individual;or(b)notify the individual thae he believa the data to be correcc. Data in disputc shall be disclosed only if the individual's statemenc of disagreemenc is included with the disclosed data. The decerminadon of the responsible au[hority may be appealed pursuant w che provisions of che adminisaaave procedure act rclating to conusud 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 turnish 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, buc refusal may require that the City deny the permit or license. 3, The infonnation may be shared with other local, state or federal agencies to the exteat necessary to process the permit or license. 4. If your requested pe�mit 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 _ Midd1F Lasc Address Ciry •,Sn�e Zip Phone I d tand my rights as stated above. GJ Signaturo -