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� Sec.13.04 RIGHTS OF SLJB.TECTS OF DATA Subd. 1. Type of data. The rightt of individual on whom the data is stored or to be stored shall be as set for[h in this secaon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal dara conceming himself shall be informed of: (a)[he purpose and intended use of the requested data wi[hin the collecting State agency,political subdivision,or sratewide sysum; (b)whether he may rofuse oY is legally required to supply the requested data;(c)any known consequence arising ftom lus supplyiag or refusing to supply private or confidendal data;and(d)the idenriry of other penons or enddes authorized by state or federal law to receive the data. This requirement shali not apply when an individual is asked to suppty invesdgadve data,punuanc to secdon 13.82,subdivision 5, to a law enforeement officer. The commissioner of revenue mav place the nodce required under this subdivision in the individual income_taz or prouem taz refund instrucdons inscead of on[hose forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whecher it is classified as public, privace or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown[he data wichout any charge to him and,�if he desires,shall be informed of the contenc and meaning of[hat dara. 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 dispute or acdon pursuanc to chis secdon is pending or addidonal dara on the individual has been collected or created. The responsible authoriry shall provide copies of the privau or public data upon request by rhe individual subject of the data. The responsible authoriry may require the requesring person to pay the actual costs of making,certifying,and compiling the copies. The responsible auehority shall comply immediacely,if possible,with any request made pursuant to this subdivision,or within five days of the date of the requesc,excluding Saturdays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannot comply with the requesc within that time,he shall so inform the individual,and may have an addidonal 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 conust the accuracy or completeness of pubtic or private data conceming himself. To exercise rhis right,an individuat shalt nodfy in wridng the responsible authority describing the namre of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiete and aaempt to nodfy past recipienu of inaccurate or incomplete data, including recipients named by[he individual;or(b)nodfy the individual that he believes[he data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with�he disclosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administraave procedure act reladng 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 shazed wi[h 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. , � �Aw�� ,� J.S�rI.J W-�� irst Middle Last �� ni"�f c�`� " - _• - Addres � �'S/ � /Z � 3�9�s��z �.��v e �+ �s /L��./ C�ty Stare Zip Phone I unders d my rights stated above. Signa re