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v • Sec.13.04 RIGEiTS OF SUBJECTS OF D�TA " Subd. 1. Tppe of data. Zhe righcs of individual on whom the daca is stor�3 or co be scoced shall be as sec forth in this secdon. Subd.2. Information reqirired to be given iadividual. An icdi�ldual asYc3 w supply private or confidenrial data concerning himsetf shail be informed of: (a)the purposc and incended use of the requested dam wi�in che eollecdng State agency,polidcal subdivision,or sratewide rysum; (b)whuher he may refuse oti is legally required co supply ehe requesud dat+;(c)any l�own eoasequence arising from his supplying or refusing to suppiy private or conndendai data;and(d)the idendry of o�her persons or enddcs 2echoriz-d by state or federal law to receive the data..This requirement shall not apply when an individual is asked to supply invesrigadve dam,pursu=^t to seccoa 13.82,subdivision 5,co a.law enforcemenc officer. Tha commissioner of revenue mav place the norice reauired erd-r this subdivision in che individual_income tax or prooem tax refund instructions inscead of on those foRns. Subd.3. Access to data by indi�idual. Upon requesc to a resroosibte aechoriry,an individual shall be informed whether he is�he subject of scored data on individuals,and whe[her it is class�ed as public,privac�or con8der.rial. Upon his further cequesc,an individual who is the subjecc of scorni priva�e or public dara on individuals shall be shown che dara wi:out any c'c�rge to him and;if he desires,sLall be informed of[he coatent and meaning of chat dara. After an indiiidual has been shown[he priva��ari and i�:ormed of ics meaning,the dara need not be disclosed to hicn for six mon�hs chereaiter unless a dispute or acrion pursuanc to ehis secdon is�elding or addidonal data on the individual has been coi[ecced or creaced. The responsible auchoriry shali provide copies af the private or public dac�L:on requ:s:by[he individua!subjec[of�he dara. The responsible authoriry may requir_[he requesring person to pay che accuai costs of makin¢,ce.=:;ing,and compiling the copies. The responsible authoriry shall comply immedia[ely,if possibI�,wich any request made punuant to[his subdivision,or wichin five days of the date of the requesc,exciuding Saturdays,Sundays and legal holidays,ii is.mediam compliance is noc possible. If he cannot comply with the request wichin tha[time,he shail so inform�he individual,and may have an addideaal five da;�s wichin which to compiy wich the�equest,�xcluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. an individuxl may concest rhe accuracy or completeness of public or private da�a concerning himself. To exercise chis right,an individual shall nodfy ia wridng�e responsible suthoriry describing che nacure of the disagreement. The respansibte aurhoriry shall wichin 30 days either: (a)cocrect the dat�{cund to be inaccurate or incomplece and aaempt eo nodfy pasc recipien�s of inaccurate or incomplete dara, including recipients named by[he individLl:or(b)�odfy the individual thac he believes the data to be coaecG Data in dispuce shsll be disclosed only if�he individual's stacemene of disagree�an�is i.cl•aded wich the disclosed dara. The de�erminarion of the responsible auchoriry may be appea:e3 pursuanc to the provisions of che adminisaarive procedure acc nladng to contested cases. . DATA PRIV:�CY AD�ZSORY In accordance with M.S. 13.04,Subd.2, "Ri�hts of subjects of data", we would like to inform you that your reauest for a permit or license from the City of Orono or any of ia deparments may require you to furnish certain private or confidential information. You are notified that: 1, The informa[ion you furnish will be used to de:emune}•our qualification for the permit or license requested. 2. You may refuse to supply data, but refusal rsay require that the City deny the permit or license. 3, The information may be shazed with ocher loc�l, state or federal a�encies to the extent neeessary to proeess the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become . . public. �, You have certain rights under M.S. 13.04 (available upon request) to review�private ilata on yourself. (, Your full name is required to process this aoplica[ion or permic. � Fint �fiddle �t Address • Ciry State Zip Phone . I under my riQ s as stated above. fi�.r�vt, --.___._._ Signacu '