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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 Yorth in this section. Subd.2. Infonnation required to be given individual. An individual asked to supply private or confidential data concerning himselfshall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may retLse or is legal ly required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or contidential data;and(d)the identiry oY od�er persons or entities authorized Uy state or federal law to receive the data.This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a la�v enforcement officer. The commissioner of revenue mav olace the notice re uired under this subdivision in the individual income tax or orooertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. 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 classitied as public,private or contidentiai. 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 ro him and,if he desires,shall be informed ofthe content and meaning of that data. After an individual has been shown the private data and informed of its meanin�,the data need not be disclosed to him for six months diereafter unless a dispu[e or action pursuanc to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of die priva[e or puUlic data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuan[to this subdivision,or within tive days o[ the date of the request,e�cluding Saturdays,5undays and legal holidays,if immediate compl iance is not possible. If he cannot comply wiYh the request within that time,he shall so inform the individual,and may have an additional five days within whidl to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not aceurate or complete. An individual may contest[he accuracy or completeness of public or private data concerning himself. To etercise d�is right,an individual shal I notify in�vriting the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notity past recipients of inaccurate�orincomplete data,including recipients named by[he individual;or(b)notify 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 determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating[o 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 furnish certain private or confidential information. You are notified that: l. The information you furnish will be used to determine your c�ualification for the pern�it 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 rec�uested permit or license requires Council action to approve, some information may becotne 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 �liddlc Last � C'� 'i�- � Address Cih� State Zip Phone I understand my riehts as stated above. � � Si�naturc Reset Form ��