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� � � Sea 13.04 RIGHTS OF SLTB.TECTS OF D?iTa 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[his secdon. Subd.2. Information reqirired to be givea individual. An individual asked to supply private or confidenual data concerning himself shall be informed of: (a)the purpose and intended use of the requested dara wi[hin the collecting�tate agency,political subdivision,or statewide system; (b)whether he may refuse oti is legally required to supply[he requesud data;(c)any lrnown consequence arising from his supplying or refusing to supply priva�e or confidendal data;and(d)[he idenrity of oeher peaons or enriries auchorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve dara, pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of re�enue mav place the norice reauired under this subdivision in the individual income tax or aroaertv tax refund inscruceions inscead of on chose forms. Subd.3. Access to data by individuai. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject of scored data on individuals,and whether ic is classified as public,privace or confidenaal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown rhe data wichout any charge to him and;if he desires,shall be informed of the content and meaning of[hat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for siz months thereafrer unless a dispute or acdon pursuanc to this secrion is pending or additional 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 subject of the dara. The responsible authority may require the requesring person to pay rhe actual costs of making,certifying,and compiling the copies. The responsible authoriry shail 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 compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional 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 conceming himself. To exercise chis right,an individual shall nodfy in writing the responsible authority describing[he nature of the disagreement. The responsible authority shall within 30 days either: (a)comct the data found to be inaccurate or incomplete and attempt to norify past recipienu of inaccurate or incomplete data,including recipients named by the individual;or(b)notify ihe 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 determinadon of the responsible au[horiry may be appealed pursuant to the provisions of the adarinistradve procedure act relating 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 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 fumish will be used to determine 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. S-�eve.v� �� S�,e Y- First ��e Last '��C�P �� -� .� )r� �'� Address — �J Ciry State Zip Phone I u my rights st d e. Signaare