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� : Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.1. Type of data T6e rlghts oi Individual on whom the aata is stored or to be stored s6s11 be as set fort6 tn this section. Subd.2. Iniormatton reqaired to be given individual. An individual asked to supply private or con£dential data rnncerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from 6is supplying or refusing to supply private or conRdential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. T61s 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. The commissioner of receoue mav olace the notice reauired under this subdivision in the individual income tax or orouertv tax refund instructions mstead of on those forms. Subd.3. Access to data by tudividual. Upon request to a responsible authority,an individusl shall be informed whether 6e is the subject of stored data on Individuals,and whether it Is classitled as public,private or contidential. Upon his further request,an individual who is the subject of stored privste or public data on individuals shall be shown the data without any charge to hlm snd,lf he desires,shall be informed of the content and mesning of that data. After an Individual 6as been shown the private data and Iniormed of its meaning,the data need not be dlsclosed to 6im for six months thereaker unless a dispute or action pursuant to this section is pending or additlonal data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by t6e individual subJect of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and complling the copies. The responsible authority s6a11 comply immediately,if possible,wlth any request made pursusnt to this subdlvision,or within Fve days oithe date of t6e request,excluding Saturdays,Sundays snd legal holidays,if immediate compliance 1s not possible.It he cannot comply with the request within that time,he shall so inform the Indi�idual,and may have an additional tive days within which to comply with the request,eacluding Saturdays,Sundays and legal holldays. Subd.4. Procedure w6ea data is not accurate or complete. An Indlvidual may contest the accuracy or completeness of public or private data concerning himseli To exercise t6is right,an individual shall notity in writing the responsible suthorlty describing the nature oi the dlssgreemenG The responsible suthority shall within 30 days elther: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or inrnmplete data,including recipients named by the individual;or(b)notify the individual t6at he believes t6e data to be correc� Data in dlspute shall be dlsclosed only if the individual's statement of disagreement is included with the dlsclosed data. The determination oi the responsible authority may be appealed pursuant to the provisions of the adminlstrative 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 con£dential 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 shared with other local,state or federal agencies to the eatent 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 name is required to process this application or permit. First Middle Last Address C��Y State Zip Phone I understand my rights as stated above. . _ �— Slgnatur