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� r Sec.13.04 RIGHTS OF S[JBJECTS OF DATA Subd. 1. Type of data. The rightc of individual on whom the data is stored or to be stored shail be as set forth in�is secoion. Subd.2. Information req�rired to be given indiv�tdual• An individuai asked�°supply private or confidential dara concerning himself shall be informed of: (a)the purpose and in[ended use of the requesced data widssn the collecting'state agency,poliacal subdivision,or stacewide system: (b)whedier he may refuse oY is legaily required to supply the requested data;(c)anY imown consequence arising from his supplying or refusing to suPP�Y private or wnfidential data;and(d)the idenriry of other persoac or entides auchorized by state or federal law to receive the data. This requiremen[shall not apply when an individual is asked to supply invesdgadve data,pursuanc ro secrion 13.82,subdivision 5,ro a law enforcement ofhcer. The commissioner of revenue mav nlace the nodce rewired under this rubdivision in the individual income tax or proaertv tax refund insnvcdons instead of on those forms. Subd.3. Access to data bp individuai. Upon requesc to a respoasi�ble authoriry,an individual shall be informed whether he is�e subject of stored data on individuals,and wherher it is class�ed as public,private or confidential. Upon tus furthec request,an individual who is the subject of stored private or public data on individuals shall be shown the dara withaut any charge to him and,-if he desires,shall be informed of the content and meaning of that data. Aher an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six montbs thereafter unless a dispute or acaon pursuanc to rhis secdon is pendin8 or addiaonal data on the individual has been collected or crea[ed. The responsible authoriry shall provide copies of the private or public data upon requesc by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costc of making,certifying.and comPilinb the copies. The responsible authoriry shall comply immediately,if possible,wirh 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 not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addidonal frve days wid�in which to comply with the request,excludiag Saturdays, Sundays and legai holidays. Subd.4. Procedure when data is not accurate or complete. An i�ividual may contest the accuracy or completeness of public or private data conceming himself. To exercise[his righG an individual shall nodfy ia wriring the responsible authoriry describing the nature of the disagreement The responsible authoriry shall within 30 days either: (a)correct the data fonnd m be inaccurace or incomplete and aaempt m nodfy past recipients of iaaccurate or incomplete data,including recipients named by che individual:or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. The determinadon of the responsible authority may be appealed pursuanc to the Provisions of the administracive procedure act relating 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 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 shazed 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 nazne is required to process this application or permit. �� G � First Middle � �/�'� �c��e f.r�ao rL fi�I/P � Addres�Y � l �y� . S� Zip Phone Ciry I understand my rights as stated above. . si re