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s . Sea13.04 RIGHTS OF SLIB.fECTS OF D�TA Subd. 1. Type oF data. The righrs of individual on whom the data is stored or co be scored shall be as sa forth in this secdon. Subd.2. Iaformation reqirired to be given individual. An individual uked to supply priva�e or confidearial dara concerning himself shal! be informed of: (a)the purpose and in[ended use of the requesud dara wichin[he collecang�tate agency,polirical subdivision,or sratewide sysum; (b)whect:er he may refuse oi is legally required to supply the cequested data;(c)any Irnown consequence arising from his supplying or refusing to suppty priva�e or confidenaal data;and(d)the idenary of other persoas or endaes authorized by sc�ce or federal law to receive the data. This requirement shalI not apply when an individual is asked to supply inv�sagadve dara,pursuan[to secdon 13.82, subdivision 5, ro a law enforcement officer. The commissioner of re�enu r-�av plac che nodc teauited under[his subdivision in the individual income rax or oropem taz refund instruccions inscead of on chose forms. Subd. 3. access to data by indi�idual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is che subjecc of scored data on individuais,and whether i�is classified as public, private or confidendal. Upon his furthzr request,aa individual who is the subjecc of stored private or public data on individuals shall be shown[he dara wichout any charge to him and,-if he desires, shall be informed of the concent and meaning of[hat dara. Aftzr an individual has been shown che priva[e data and informed of i�s meaning,the data need not be disclosed to him for six monchs�hereaner unless a dispute or acdon pursuanc to chis secaon is pending or addiaonal data on the individual has been collecced or crear�d. 'Ihe responsible auchoriry shall providz copies of the privace or public data upon request by the individual subject of the daca. The responsible authoriry may require rhe requesdng person to pay the accual coscs of making,cercifying,and compiling the copies. The responsible au[horiry shall comply immediately, if possibte, wi�h any request made pursuant to this subdivision,or wi[hin five days of the date of che requesc,excluding Saturdays,Sundays and legal holidays,if immediate compliance is noc possibie. If he cannot comply with the request wichin rhat rime,ht shall so inform ehe individual,and may have an addidonal five days wichin which to comply wich the request,excluding Saturdays, Sundays and legaC holidays. • Subd:4. Procedure when data is not accurate or complete. An individual may concesc thz accuracy or completeness of public or pm•ate da[a conceming himself. To exerciSe this ri¢ht,an individuai shall nodfy in wridng ehe cesponsible auchoriry describing the nature of the disagreement. The responsible au[horiry shall within 30 days either: (a)correct the data found to be inaccurate or incomplece and attempt to nodfy past recipiencs of inaccurate or incomplece data, including recipiencs named by che individual; or(b)nodfy[he individuaI th��he believes[he data to be correcc. Data in dispute shall be disclosed only if�he individual's stacemtnt of disagreement is included wi[h the disclosed data. The decerminadon of the rasponsible au�horiry may be appealed pursuanc to the provisions of the adaunistrarive procedure act relating to con[ested cases. DATA PRIVACY ADVISORY In accordance wi[h M.S. 13.04, Subd.2, "Ri;.hts 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 thar. 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 wich other local, stace or federal a;encies to the ettent 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 riQhts 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 perm.it. S��r= �/�-0�0 T Firsc �Siddle Lasc Address Ciry Sate Zip Phone I understand my ri�hcs � stated above. � Signature