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t � Sec.13.04 RIGHTS OFSUBJECTS OFDATA �-� � Subdivrsion 1. Type ojdata The sights of individual ox whom the data is stored or to be slored sha116e as set forth in this section. Subd 2. Injormation required to be gfven lndividuaL An individual asked to supply private or confrden�ia/data concerning/rimself shall be informed of (a)the purpose and rntended use of the requested dala withi»the collecti»g state agency,politrcal subdivision,or statewide system;(6)whether he may refuse or rs legally requised to supply the requested data;(c)arry/mown consequence arisingfrom his supplying or re,f+rsing to supply private or confrdential data;and(d)the iden�ity of o�her persons or entities authorized by state orfederal law to receive the data. This requirement shall not apply when an individual is asked to supply irrvestigative dala,pursuant to section 13.82, subdivision S, to a law enforcement off:cer. The commissioner ot severrue mav vlace the notice reauired under�his subdrvision rrr the individual income tax or nronertv tax sefund instnrctrorrs irutead ot on those torms. Subd.3.Access to data by individuaL Upon request to a responsible authority,an individual s{rall be rnformed whether he is the subject of stored data on indivrduals,and whelher it is classified as public,private or confrdentral. Upon his further request,an indrvidual who is 1he subject of stored private or public data on indrviduals shal!be shown the data without nxy charge to him and,if he desires,shall be informed of [he content and meaning of that data. AJter an irulividual has been shown the private data and rnformed of its meaning, the data need not be disc%sed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additronal data on the individual has been collected or created. The respousible authority sha!!provide copies of the private or public data upon request by the individual subject oJ the data. The responsible au�hority may require the requesting person to pay fhe actual costs ojmaking,cert�ing,and compiling the copies. The resporrsible authority shall comply immedrately,if possible,with a�ry request made pursuant to this subdivision,or wrthin frve days of the date of the request,excludixg Saturdays,Sundays and legal holydays,rf immedrate compliance is not possible. I,f he cannot comply with the request within that time,he shal/so rnjorm the individual,and may have an additioual frve days within which to comply with the request,excluding Saturdays,Sundays and lega!holidays. Subd.4. Procedure when data Ls not nccuratt or complet�An individual may contest the accuracy or completexess ofpublic or private data concerning himself. To exercise this right, an indivrdual shall not�in writing the responsible authority descrrbing the nature of the disagreement. The responsible cruthority shall within 30 days either: (a)correct the data found to be irraccurate or rncomplete and aJtempt to not� past recipients of inaccurate or incomplete data,includrng recipients named by the individual,•or(b)not�the individual that he believes the data to be correct. Data in dispuJe shall be drsclosed only rf the individua%s statement of disagreemenl is rncluded with the disclosed data. The determination oJthe responsible authority may be oppeo[ed pursuant to the provisions of the administrative procedure oct relating to contested cases. DATA PRIVACYADVISORY ln 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 1 icense from the City of Orono or arry of its departments may requrre you to furnish certain private or confidential information. You are notifred that: l. The information you Jurnish will be used to deterneixe your qualification for the permit o�/rcense�equested. 2. You may refuse fo supply data,but refusal may require that the Crty derry the permil or/icense. 3. The information may be shared with other(ocal,state or federal agencies�o the extent necessary to process the permit or license. 4. Ijyour requested permit or licexse requires Council actron to approve,some info�mation may become publrc. S. You have certarn rights under M.S 13.04(see jollowing page)to review p�ivate data on yourself. 6. Your full name is required to process this app/ication or permit • PLEASE PRINT �N/n� � ��sU� First Middle Last —jl.�u C�/9./L c S b�v ��w y � 3� Address Ft yM�nf, �� s�� cd � -.i�'�-� 3� City State Zip Phone I under ri s above. / Si re /0