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. ,� , Sec.13.04 RIGATS OF SUBJECTS 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 secdon. Subd.2. TnformaHoa re�mired to be given indivtdual. An individual asked ro supply private or confidential data concerning himself shall be u�formed of: (a)the purpose and intenrled use of the requested data within the collecting state agency,poliacal subdivision,or statewide system;(b)whether he may refuse or is legally required W supply the requested data;(c)any]rnown consequence arising from his supplying or refusing to supply private or confidecrtial data;and(d)the identity of other persons or e�ries authotized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revernie mav olace the nodce reauired under this subdivision in the individual income tax or nrooertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. U�n request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and w6ether it is classified as public,private or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown die data without azry charge to him and,if he desires,shall be informed of the conteut and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six moaths thereafter unless a dispute or action pursuant ro this section is pending or addidoaal data on the individual has been collecoed or creaoed. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person w pay the actual costs of matdng,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,widi any request made pursuant to dris subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. ff he cannot comply with the request within that dme,he shall so inform the individual,and may have an addidonal five days within wluch to comply with the request, excluding Saturdays,Sundays and legal holidays. Subd.4. Procalure when data is not acc�ate or complete. An individual may contest the accuracy or compl�teness of public or private daoa co�eming himself. To ezercise this right,an individual shall notify in writing the responsible authority describing tha�nature of the disagreemetu. The responsible authority shall within 30 day�ei@►er: (a)correct die daha fouml to be inaccuiate or incomplete and attempt to�rify past recipiems of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with die disclosed data. The determinadon of the respons�ble authority may be appealed pursuant to the provisions of the administraave 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�ity of Orono or any of its departments may require you to fumish certain private or confidential information. You aze 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 Ciry 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(availabie upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. First Middle Last Address Ciry State Zip Phone I understand my rights as stated above. Signature a 6