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�� � -. Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The righcc of individual on whom[he dara is stored or to be stored shall be as set forth in this secdon. Subd.2. Informadon reqirired to be givea individual. An individual asked to suppiy private or confidenaai data conceming himself shall be informed of: (a)[he purpose and inrended use of the requesied data within the collecdng state agency,polidcal subdivision,or sratewide rystem; (b)w6ether he may refuse oY is legaily required to supply the requested data;(c)aay imown consequence arising from his supplying or refusing w supply • private or confidendal data;and(d)the idcndry of other persoas or enades au[horized by state or federal law to receive rhe data. This requ'uement shall not apply when an individual is asked to supply invesdgadve dara,pursuanc to secdon 13.82,subdivision 5,to a law enforeement o�cer. - 'Ihe commissioner of tevenue mav place the notice reauired under this subdivision in the individual income rax or propertv tax refund instrucdons inscead of on chose forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individua!shall be informed whether he is the subject of stored data on individuals,and whecher it is classified as Qublic,private or confidendal. Upon his further request,an individual who is the subject of swred private or public data on individuals shall be shown the dara wichout any charge to him and,-if he desires, shall be informed of the content and meaning of that data. Afur an individua!has been shown the private data and informed of its meaniag,the data need aot be disclosed ro him for six mondu thereafur unless a dispuu or acdon pursuan[to this secaon is pending or addidonal dara on che individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesring person to pay the actual cosu of making,cerafying,and compiling the copies. The responsible aurhoriry shall comply immediately, if possible,with any request made pursuant to this subdivision,or wi[hin five days of the date of the request,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with[he request within[hac time,he shall so inform che individual,and may have an addiaonal five days wi[hin wluch to comply with the request,excluding Sacurdays, 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 dara concerning himself. To exercise�his right,an individual shall nodfy in writing che responsible authoriry describing the nature of the disagreemenG The responsible authority shalt within 30 days either: (a)correct rhe data found w be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete dara,including rocipients named by the individual;or(b)nodfy the individual that he believes[he data to be correc� Data in dispute shall be disclosed only if the individual's statement of disagreement is included with�he disclosed data. The determinaaon of the responsible auchoriry may be appeated punuant to the provisions of the administradve procedure act relacing 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 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 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. 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 permic. � �� First Middle � `� Lasc ZZ(�� G�S�z��'� ��- Address /�t� ��(/ . v�8�c�✓4 � Ciry Stace Zip Phone I under d my righ stated above. c signacure