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► . , . � Sec.13.04 RIGHTS OF SUBJECTS OF DATA � � Subd. l. 1'ype of data. The cights of individual on whom the data is stored ar to be stored shall be as set forth in this section. Subd.2. [nformation required to be given individual. An individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and in[ended use of the requested data within the collecting sta[e agency,political subdivision,or statewide system;(b) whether he may refuse or is legaily required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private o�contidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not appiy when an individual is asked to supply investigative data,pursuant to section 13.32,subdivision 5,to a(aw enforcement officer. The commissioner of revenue may place the notice reouired under this subdivision in the individual income tac or oropertv tac refund instructions instead of on those fortns. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shatl be informed whethcr he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his fuRher request,an individual who is the subject of stored private or public data o�individuals shall be shown the data without any charge to him and,if he desires,shall be infortned of the content and meaning of tha[data. After an individual lias been shown the private data and informed of its meaning,lhe data need not be disctosed to him for si�c months thereafter unless a dispute or action pursuant to this section is pending or additional da[a on the individuai has been collected or created. The responsible authority shall provide copies of the private oc puUlic data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comp{y immediately,if possible,with any request made pursuant to this subdivision,or within five days ofthe date of the request,ercluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply wi[h the request within that time,he shait so infortn the individual,and may have an additional five days wichin which to comply with the request,ercluding 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 concerni�g himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)coRect the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be coirect. Data in dispute shali be disclosed oniy if the individual's statement of disagreement is included with the disciosed data. The determination of the responsible autliority may be appealed pursuant to the provisions of the administrative 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 pernut or license from the City of Orono or any of its departments may require you to furnish certain private or confidential infoimation. You are notified that: 1. The informarion 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 pernut or license. 3. The informarion may be shared with other local, state or federal agencies to the extent necessary to process the pemut or license. 4. If your requested pernut or license requires Council action to approve, some information rnay become public. 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. � You 11 name is required to process this application or permit. � l � Cl � First�� hliddle Last �1 �-� ' r ,M d Gl� �re1 V�V �„' �� -F _ I City State Zip hone � � � nderstand m�r ri t s ated above. , � ' � ' . ,�� '� � l,/�.�l.�i!!�-� ture 10