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. —. a- Sec.13.04 RIGii'TS OF SLJBJECTS OF D.aTA Subd. 1. Type of data. The righ[s of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information reqirired to be given individual. An individual azked to supply private or confidendal dara concerning himself shall be informed of: (a)the purpose and inrended use of the requesud data within the collecting Stare agency,potitical subdivuion,or statewide system; (b)whether he may refuse ot is legaily required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing to supply private or confidendal daca;and(d)the idenriry of o[her persons or enudes authorized by state or federal law to receive che data. This requirement shall not apply when an individual is asked to supply investigaave data,pursuant to section 13.82,subdivision 5,to a law enforcement o�cer. The commissioner of re�enue mav alace the nodce re4uired under this subdivision in the individual income tax or propertv tax refund instructions instead of on[hose forms. Subd.3. Access to data by individual. Upon requesc to a responsible au[horiry,an individual shall be informed whether he is the subject of stored data on individuals,and whe[her ic is class�ed as pubiic, priva[e or confidendal. Upon his further request,an individual who is the subjecc of stored private or public data on individuals shall be shown the dan wichout any charge to him and,-if he desires,shall be informed of the content and meaning of fiat data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hicn for six months thereafter unless a dispute or acaon pursuanc co 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 subjecc of the data. The responsible authority may require the requesting person to pay the actual costs of making,cerdfying,and compiling the copies. The responsib(e authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,ezcluding Saturdays,Sundays and legal holidays,if immediate compiiance is not possible. If he cannot compty with the request within that time,he shall so inform the individual,and may have an additional five days within wtuch to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Proeedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise chis right,an individual shall nodfy in writing the responsible authoriry describing rhe nature of the disagreement. The responsible authoriry shail within 30 days either: (a)correct[he 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 that he believes the data to be correct. Data in dispute shali be disclosed only if the individual's statemenc of disagreemenc is included with the disctosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relating to contested cases. DATA PRNACY 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 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 shazed 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 permic. � - vlid e Last �rst I � � �� l Ad �/V �J^ � ! � � J City Sta Zip Phone ecstand my � ht st ed ove. Signa re