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w� � � Sec.13.04 RIGHTS OF SiJBJECTS OF DATA Subd. 1. Type of data. The rigLcs of individual on whom the dara is sWced or to 6e stored shall be as set fonh in this secaoa S�bd.2. Information c�eqmred to be givm indioidual. An individuai asked to suPP1Y Private or confidendai data concerning himself shall be informed of: (a)[he purpose and inoended use of the�equesud data wichin the collecting§tate agency,poGdcal subdivision,or saoewide sysoem; (b)whether he may cefuse or is legally required to sa4P1Y��n9u�data;(c)any known consequence azising from his supplying or refusing to supply privau or confidendal data:and(d)ehe idendry of other pecsoas or enddes authorized by stau or federal law to receive the data. This iequusme�shall not apply when an individual is asked to supply invesdgadve data,punuant to secdon 13.82,subdivision 5, to a law enforcement officer. 'Ihe commissioner of reveaue mav alace the noace required under this subdivision in the individual income rez or aropem taz refund instrucrions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whecher it is classified as public,private or co�dential. Upon his further request,an iadividual who is the subject of stored privare or public data on individuals shall be shown[he dara wi[houc aay charge to him and;if he desires,shall be informed of the conrent and meaning of that data. Afur an individual has been shown the private data and informed of itc meaning,the data need not be disclosed w him for six months thereafttt unless a disputt or acdon pursuant to this section is pending or addidonal dara on the individual has been collected or enated. The respoasible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsibie authoriry may require[he requesring peaon to pay the acmal costs of making,certifying, and compiling the copies. The responsible au[hority shall compiy immediately, if possible, with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Sanirdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannoc comply with the request within thac time,he shall so inform che individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays, Sundays and legal 6olidays. 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 ezercise this right,an individual shall notify in writing the responsibie authority describiag the nature of the disagreemeat. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and atumpt to notify pasc recipiencs of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data W be correct. Data in dispuu shall be disclosed only if ti�e individual's statement of disagreement is included with the disclosed data. The determinaaon of the responsible authoriry may be appealed pursuant w the provisions of the adminisnadve procedure act relating to contesud 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: i, The information you furnish 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 eztent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. g, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. (. Your full name is required to process this application or permit. f"l,K�-1� W;��F�t••� �►s'--� F�� Middle �� �S� �`'►�It�1.�'1zx�'.� �31.��(J � 2--E�4 aaanss �l�v 2�i MIJ SS��t� �c2— ��3 -2�—� � C� S�� ZIp Phone I understand my righu as stated above. Si mre