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Sec.13.04 RIGHTS OF SLJBJECTS OF DATA Subd. 1. Type of data. Ihe rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqtrired to be giren individual. An individual asked w supply private or confidendal data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecung State agency,political subdivision,or statewide system; (b)whether he may refuse oY is legatty required to supply the requested data;(c)any Imown consequence arising from his supplyiag or refusing to supply privace or confidenaal data;and(d)the idenury of other persons or enriaes auchorized by state or federal law to receive the data. This requirement s6a11 not apply when an individual is asked to supply invesdgadve data,pursuant to secdon 13.82,subdivision S,to a law enforcement o�cer. The commissioner of re�enue mav oiace the nodce reauired under this subdivision in the individual income tax or nrooertv taz refund inst�ucdons instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsibie authoriry,an individual shall be infonned whether he is the subject of sWred 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[he data wichout any charge to him and;if he desires,shall be informed of the coatent and meaning of chat data. Afrer an individual has been shown the privace data and informed of its meaning,the data need not be disclosed to him for six mondu thereafter unless a dispute or acaon pursuanc to this secdon is pending or addiaonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the privau or public data upon request by the individual subject of the data. The responsible authoriry may require the requesdng penon to pay the actual costs of making,certifying,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 compiiance is not possible. If he cannot comply with the request within that tirne,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. M individual may contest the accurdcy or completeness of public or private data concerning}ivnself. To exercise rhis right,an individual shall notify ia wriang the responsible authoriry describing�he nature of the disagreement The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt W nodfy past recipients of inaccurate or incomplete data, including recipients named by the individual;or(b)aotify the individua!that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of d'uagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant w the provisions of the adminisaarive procedure act relating to contesud 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 furnish certain private or confidential information. You aze 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 peraut 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 acdon 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. � �� J� Fint �i y�� Middle Last v � Address . J��/,� S�f/��' ��3�..�3 5��-1.. Ciry State Zip Phone I understand my rights as stated above. ig t