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� Sec.13.04 RIGHTS OF S[JB.TECTS OF DATA Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private ot confidendal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecdng"state agency, poliucal subdivision,or sratewide system; (b)whe[her he may refuse oY is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supp(y ' private or confidential data;and(d)[he idenary of other persons or enrides auchorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrieaave data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the nodce required under this subdivision in the individual income tax or propertv tax cefund instructions ins[ead of on those 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 whe�her ic is classified as public, private or confidenaal. Upon his further request, an individual who is the subject of stored private or public data on individuals shall be shown the data wi�hout any charge to him and, if he desires, shall be informed of the content and meaning of that data. After an individuai has been shown the private data and informed of iu meaning,the data need no[be disclosed to him for six months thereafter unless a dispute or action pursuan[to chis secdon is pending or addidonal 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 data. The responsible authority may require[he requesring person to pay the actual cosu of making. cerrifying,and compiling the copies. The responsible authoriry shall comply immediatety, 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 no[possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,exciuding 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 this right,an individual shall nodfy in wridng the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correcc the data found to be inaccurate or incomplece and attempt to norify past recipients of inaccurate or incomplete data, including cecipients named by the individual; or(b)notify the individual that he believes the data to be correcc. Data in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrarive procedure act relaang 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 depar[ments may require you to furnish certain private or confidential information. You are 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 extent necessary to process the pemut or license. 4. If your requested permit or license requires Council action to approve, some information may become public. $, 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. V/ ��2��K.son� �D L��i I G�S First Viiddle_ Last �� oi� � V,e.�..� 1��i Je Address -7S�� Lo n�i ��e /�Q�'�° Nc.�.� s��.s'?� � C�ty State Zip Phone I unders and my rights as stated above. � Signamre