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See.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored oi to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked tosupply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collectir collect' g§tate agency,political subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any known comsequence arising from his supplying or refusing to supply • private or confidential.data;and(d)the identity of other persons or entities authorized by stn or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13. 2,subdivision 5, to a law enforcement officer. - The commissioner of revenue may place the notice reouired under this subdiv sion in the individual income tax or i3roperty tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authori ,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 further request,an individual who is the subject of stoned private or public dam on individuals shall be shown the data without any charge o 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 informe I of its meaning,"the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or addit onal data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by C a individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and comp'ing the copies. The responsible authority shall comply immediately,if possible,with any reques made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compl ance is not possible. If he cannot comply with the request within that time,,he shall so inform the individual,and may have an additional five days witb in which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual ma contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be' rate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify 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 the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISO Y 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 th it the City deny the permit or license. 3.-' 'The information maybe shared with other local, state or fed-ral agencies to the e7,tent necessary to process the permit or license. 4. If your requested permit or license requires Council actio a 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 p rmit. First Middle Last Address �777 City State Zip Phone I understand my rights as stated above. Signamre