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I / J o �- . . �+' � , � Sec.13.04 RIGHTS OF SUB3�CTS OF DATA S�bd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in Uus section. Subd.2. Informabton reqoired to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)die purpose and'mteffiied use of�e requested data within the collecting staoe agency,polidcal subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requested data;(c)azry lmown consequence arising firom his supplying or refusing to supply private or confide�ial data;and(cn the identity of other persons or emiries authorized by state or federal law to receive the data. '17�is requirement.shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82, subdivision 5,to a law enforcement officer. • � Ttte commissioner of revern�e mav nlace the notice reauired under this subdivision in the individual income tax or nroneriv ta�c refund nostrucdons instead of on those forms. Subd.3. Acce�to data by iindividual. Upon request w a respflnsible authority,an individual shall be i�ormed whether he is the sUbject of stored data on individuals,and whether it is classified as public,private or confide�ial. Upon his further request,an individual who is die subject of stored privaoe or public dam on individuals shall be shown die data without any charge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of itc meaning,the data need not be disclosecl to him for six momhs theteafter unless a dispute or acrion pursuant to this section is pe�ing or additional data on the individual has been wIlecoed or created. The responsible authority shall provide copies of d►e private or public dala upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The respons►ble authority shall comply immediately,if posst'ble,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays aad legal holidays,if immediate compliance is not possible. If he cannot comply widi the request within that time,he shall so inform the individual,and may have an additio�l five days witLin which to comply with the request, e�ccluding Saturdays,Sundays and legal holidays. Subd.4.•Procedure when data is not accarate or complete. An individual may contest the accuracy or completeness of public or private data concetmng himcelf. To exercise this right,an individual shall natity in wricing the•responst'ble authority descn'bing the nature of the disagreeme�. The respons�ble authority shall withm 30 days ei�er: (a)correct d�e data found to be inaccucate or incomplete and atbempt to nodfy p�ast recipiems of inaccurate or incomplete data,i�lud'mg recipients named by the individual;or(b)norify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statemem of disagreement is included with the disclosed data. The determimAtion of the respons�le authority may be appealed pursuant to the pmvisions of the administradve procedure act relating to contested cases. AATA PRIVACY A►DVISORY 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 Gity of Orono or any of its departments may require you to furnish certain private or confidential informarion. , You aze notified that: 1. The information you futnish 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 acdon 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 pro s ' application or permit. . � �� e/ �� r� � , A`�� /��%� ��1/ o��c3�� City State Zip Phone I understan ts as stated e. • Sigffiture