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�Y OF ORONO 6124730510 09/24/96 14:00 15 003/0*3 Nb.522 See.13,D4 RIGHTS OF SUMMS OF DATA Subd. 1. Type or data. ` r tights of individual oth whom the data Isstoredor to be stored shail be as set forth In this section. Subd.3. Wottmation regsairad to be gi®en Individual. An individual asked to supply private or confidead&I data concerning himself shall be Informed of., (a)die purpose and intended use of the requested data within the collecting hate agency,polldcal subdivision, or statewide system: (m)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private breodfldendal data;and(d)the idenrity of other persons or endues authorized by state or federal law to receive the data. This requirement shall trot apply when an Individual is asked to supply Invesdgadve data.pursuant to section 13.82, subdivision S,to a law enforcement officer. e c2miBigsigilgr 12Lrovenue mqv olace the notice rewired under this subdiviOnn in the individual income tax or orowt:tcy rex;rcf6d lnsttvctiona la itd of on those forms. „ Subd, 3. Arrest;to data by Individual. Upon request to a mspnttsible authority,an Individual shall be informed whether he Is the subject of stored data on individuals,and whether k is classified as public,private or conrldendal, Upon his further request,an individual who is the subject of stored privtue or public data an individuals shall be shown the data without any charge to him and,'if he desires,shall be informed of the content and niftning of that daut. After an individual has been shown the private data and Wormed 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 additional data on the individual has been collected or created. no mapunsible auftrity shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may requite the requesting person to pay the actual costs of making,cardfying.and compiling the copies. The responsible authority shall comply immediately, if possible,with any request made pursuant to this subdivision, or within five days of tha date of the requesr,excluding Saturdays.Sundays and legal holidays,if immediate compliance is not possible. If1 he cannot comply with the request within that tlme,he shall so inform rhe individual,and may have an additional five days within which to comply with the request,excluding Saturdays. Sundays and legal holidays. Subd.4, Ptrotedure whore data is not accurata or complete. An individual may contest the accuracy or complerenom of public or private data concerning himself. To exercise this right.an individual shall nodfy in writing the responsible authority describing die nacure of the disagreemcnt. The msponolble authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or iruaroplete dam, including rtcipientt named by the individual;or(b)nodfy the individual that he believes the data to be catraeL Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. 'rite determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedute act relating w contested cases. )DATA, PRIVACY APVI$ORY In accordance with H.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 dwa, but reftnal 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 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 fait name is required to process.this application or permit. iddl LUL , ' 1 ss�a a 9sa CJty Stere Zip Phone I.understand luny rights as stated above. t , Signature