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Sec.13.04 RIGHTS OF SiJB,TECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secaon. Subd.2. Iaformation required to be given individual. An individual asked to suppiy private or confidendat data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within[he collecting state agency,poliacal subdivision,or statewide rystem;(b)whether he may refuse or is legally required to suppiy the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidendal dara;and(d)the idendry of ocher persons or enaaes authorized by sate or federal law to receive the data. 'Ihis requirem�nt shall not apply when an individual is asked to supply investi;adve data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav olace the norice reouired under this subdivision in the individual income taz or oro�ercv tar refund instrucrions mstead 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 whether it is classified as public,private or confidential. Upon his furthec request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any char�e to him and, if he desires,shall be informed of the content and meanin�of that data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafrer unless a dispute or acaon pursuant to this secoon is pending or addirional data on the individual has been collected or created. The responsible authoriry shall provide copies of the priva[e or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the actual costs of making,certifyin„and compiling the copies. The responsibie authoriry shall comply unmediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Su�days and legal holidays, if immediate compliance is not possible. If he cannot comply with the request wi[hin that time, he shall so inform the individual, and may have an additionai five days wittun 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 contest the accuracy or completeness of public or private dara concerning himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplete and attempt to nocify past recipients of inaccurate or incomplete dara,including recipients named by the individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disclosed oniy if the individual's statement of disagreement is included with the disclosed data. The detzrminaaon of the respoasible authoriry may be appealzd pursuant to the provisions of the adminis�ative procedure act relating to contested cases. DATA PRNACY 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 furnish certai.n 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[he 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 private data on yourself. 6. Your full name is required to process this application or permit. af; � L First /� �r� 1 M�ddle Last d ess� � 51�v� D r - w�.� r`" �X�Op t �V'�1,��✓` �4�i W✓V ,55�L/ �� Dwv �.�3qi �erz-s��zsry `'"y - State Zip Phone I unde t d my riQ ts as tated above. /� r Si re 6