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� , . Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given indiridual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and inceoded use of the requested dara wichin the cotlecting state agency,polidca!subdivision,or sratewide rysum;(b)whecher he may refuse or is legally required to supply the requested dara;(c)any Imown consequence arising from his supplying or refusing to supply private or confidenaal data;and(d)the idenary of other persons or enrides authorized by srate or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesNgadve data,pursuant to secdon 13.82, subdivision S, to a law enforeement o�cer. 'he commissioner of revenue mav olace the noece reauired under this c��bdivision in the individual income taz or n ertv tax refund instrucdons�nstead of on those forms. Subd.3. Access to data by indiridual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,privau or co�denaal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,if he desiros,shall be informed of rhe content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the dara need not be disclosed to him for six months thereafter uniess a dispute or acaon pursuant w thissecaon is pending or addiaonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public dara upon request by the individual subject of the data. The responsible authoriry may require the requesdng person w pay the actual cosu of making,certifying,and compiling the copies. The responsible authoriry shall comply immediately,if possible,with any mquest made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request wirlvn 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 accuracy or completeness of public or private data concerning himself. To eaercise this right,an individual shall nodfy in wridng the responsible authoriry describing the nature of[he , disagreement. The responsble authoriry shall within 30 days either: (a)correct the data found ro be inaccurate ar incomplete and aaempt to nodfy past recipiencs of inaccurate or i�omplete data,including rocipients named by the individual;or(b)no6fy the individual that 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 data. The dererminadon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relaang 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 �iry of Orono or any of its departments may require you to furnish 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. 6. Your full name is required to process this application or permit. First Middle Last Addross C�h' State Zip Phone I understand my rights as stated above. , SignaNre • 6 . ,