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Sec.13.04 RIGHTS OF SUBJECTS OF DATA I Subd. 1. 1�pe of data. The rights of individual on whom the data is sWred or to be stored shall be as set forth in tlus section. � S�bd.2. Information req�rired to be given individual. An individual asked to supply private or confidential dara concerning himself ' shall be informed of: (a)die pn�rpose and inte�ed 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 laiown consequence arising from his supplying or � refusing to supply private or confidential data;and(d)the idenary of other persons or entiaes authorized by state or federal law to receive the data. � This requirement shall not apply when an individual is asked to supply investiga6ve data,pursuant to.section 13.82, subdivision 5, to a law ' enforcement o�cer. I The commiccioner of revenue mav olace the nodce rewired under this subdivision in the individual income tax or oronertv taz refund instructions instead of on those forms. � Subd.3. Access to data by individual. Upon request to a responsible authoriry,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 lus further request,an individual who . is the subject of stored private or�blic data on i�ividuals shall be shown the data without azry charge to him and,if he desires,shall be informed of the content and meaning of that data. After an inciividual has been shown the private data and informed of its meaning,the data need not be disclased to him for six months thereafter unless a dispute or action pursuant to this section is pending or additioual data on the individual has been collected or created. The responsible authoriry shall provide copies of die private or public data upon request by the individual subject of the data. The responsible authoriry may nquire the requesting person to pay die actual cosu of making,certifying,and compiling the copies. The responsible authoriry.shall wmply immediately,if possble,with any request made pursuant w this subdivision,or within five days of the date of the request,excluding Saturdays,Sandays and legal holidays,if icnmediate compliance is not possible. If he cannot comply with the request within tl�at time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request, excluding Sawrdays,Su�lays and legal holidays. S�bd.4. Procedure when data is not accurate or complete. An indiyidual may contest ihe.accaracy or completeness of public or private data concerning himself. To ezercise this right,an individual shail notify in writing the•responsible authority describing the nature of the disagreement.�Tl�e responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt w nodfy past recipients of inaccurate or i�onuplete data,i�ludiag 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 the disclosed data. The determination of the responsible authoriry may be appealed pursvant to the provisions of the administrative procedure act rela6ng w contested cases. -DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Rights of subjecis 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 information. You aze notified that: 1. The information you fumish 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 shar�d with other local, state or federal agencies to the eztent necessary to process the permit or license. � � ' ' � 4. If your requested permit or license requires Council acdon to approve, some information may become publia 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. i `'� � i� u..T'+4W5k.� First Middle Last ��6�' � (�c a� ss�s� ' , UYIEc��,ri ;Mti1 �F3� �f?.5=1160 • ' City State Zip Phone underst my rights as ted above. � � � signa ' � . 6