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. Sec.13.04 RIGHTS OF SiJB.TECTS OF DaTA • Subd. 1. Type of data. The righcc of individual on whom che data is stored or co be stored shall be as set for[h in this secrion. Subd.2. Informatioa reqirired to be given individual. An individual asked to suppiy priva[e or confidenaai dara concerning himself shall be informed of: (a)the pucpose and inunded use of the requesce�data within the collecting�tate agency,political subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply the mquested data;(c)any irnown consequence arising from his suppiying or refusing to supply priva[e or confidendal data;and(d)[he idenury of other persons or enrides auchorized by state or federel law to receive the data. This requirement s6a11 not apply when an individual is asked to supply invesrigadve dara, pursuant to secdon 13.82,subdivision 5, to a law enforcemenc officer. The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or prooem taz refund instructions ins[ead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authority,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 confidendai. Upon his further request,an individuai who is the subject of stored private or public dara on individuals shall be shown che dara 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 disclosed to him for siz 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 responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the dara. The responsible authority may require the requesting person to pay the accual coscs of making,certifying,and compiling the copies. The responsible authoriry shall comply immediacely,if possible,with any request made pursuant to this subdivision,or within five days of the date of the requesi,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 addiaonal five days within which 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 accuncy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in wricing the responsible authority describing[he nature of the disagreement. The responsible au[horiry shall within 30 days ei[he�: (a)correct the data found to be inaccurate or incomplete and aaempt to nodfy past recipienu of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual thac he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed dara. The determination of the responsible authoriry may be appealed pursuant to the provisions of the adatinistradve 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 pemut 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. 5, 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. First Middle Last Address C�� S[ate Zip P6one _... . I understand my rights as "atstive: =-�--__ ' Signature