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. � . � w - � � Sec.13.04 RIGH'FS OF SUB.TECTS OF DATA Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth in 8us section. Subd.2. Information required to be given individual. An individual asked ro supply private or confidential data concerning himself shaq be mformed of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lrnown consequence arising from his supplying or refusing to supply private or confidential data;and(�the identiry of other persons or entities authorized by state or federal law ro receive the data. This requirement shall not apply when an individual is asked to supply investigarive data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revertue tnav olace the tatice reauired under this cybdivision in the individual income taz or�certv taz refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual s6all be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or co�denrial. Upon his further request,an individual who is the subject of stored private or pubiic data on individuals shall be shown the data without any charge to him ac�,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six months thereafter unless a dis�rute or acaon pursuant to this secdon is pending or additional data on the individual has been collected or created. The cesponsible authority shall provide copies of the private or�xtblic data upon request by the individual subject of the data. The responsibte 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 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 comply with the request witkrin that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request, ezcluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data is aot accurate or complete. An i�ividual may contest the accuracy or completeness of public or private data co�erning himself. To exercise d�is right,an individual shall nodfy in writing the responsible authority describing the nature of the disagreemem. The responsble authoriry shall within 30 days either: (a)corceet the data found ro be inaccurate or i�omplete and attempt to notify past recipients of inaccucate or i�omplete data,i�tuding recipienu named by the individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagteement is included with die disdosed data. The determinaaon of die responsible authoriry may be appealed pursuant to the proyisions of the administrative procedure act relating w 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 Gity of Orono or any of its depaztments may require you to furnish certain private or confidential information. You aze notified that: 1. 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. 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 Middle Last Address C��y, State Zip Phone I understand my r' as st bove. Signature 6