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Sec.13.04 RIGHTS OF SUBJECTS OF DATA S�bd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be gtven indlvtdual. An iadividual asked to supply private or confidential data co�erning himself shall be informed of: (a)the purpose and i�eaded use of the requested data within the collecting state agency,poliacal subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from tus supplying or refusing to supply private or confidendal data;and(d)the identiry of other persons or endties authorized by stau or federal law to receive the data. This requirement shall not apply when an individual is asked to supply inyesdgative data,pursuant to sectioq 13.82,.subdivision 5, to a law enforcement officer. Thr�n.,,m;ecinner nf revemie mav olace the notice reauired under this subdivision in the individual income faz or mm�ertv taz refund instructions insuad 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 swred data on irxlividuals,and whether it is class�ed as pubGc,private or confidential. Upon his further request,an individual who is the subject of stored private or pablic data on individua(s shall be shown the data without any chazge W lrira and,if he desires,shall be informed of the content and meaning of that data. After an individoal has been shown the private data and informed of its meaning,the data�ed not be disclosed to him for six months thereafter unless a dispute or ac6on pursuant to this secaon is peiding or additional data on the individual has been coUected or created. Zbe respons�le authority shall provide wpies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. The respoffi�le authority.shall comply immediately,if possible,with azry request made pursuant oo this subdivision,or within five days of the dau of the request,excluding Sawrdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with t6e nquest within diat time,he shall so inform the individual,and may have an addidonal five days within wtrich to comply with die request, excluding Saturdays,S�ndays and(egal holidays. S�bd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or complete�ss of public or private data concerning himself. To exercise this right,an i�ividual shall nodfy in writing the respoasible authority describing the nawre of the disagreemetu. The respocuible auttwriry shall within 30 days either. (a)corroct the data found to be inaccurate or mcomplex and attempt to notify pest recipients of inaccuraoe or incomplete dam,i�luding recipients named by the individual;or(b)notify the individual that he beGeves the data ro be correct. Data in dis{wte sha(I be disclosed only if the individual's sffitement of disagreement is i�luded with the disclosed data. The determiaaflon of the respoaS�le awhority may be appealed pursvant to the provisions of thc administrative procedure act relaang 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 pemut or license from the Gity of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified that: 1. The informadon 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 shared with 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 privafe data on yourself. 6. Your full name is sequired to process this applicauon or permit. First Middle Last ?►ddress Ci�y State Zip Phone I understand my rights as stated above. � Signawre � 6