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� Sec.13.04 RIGH'fS OF S[TBJECTS OF DATA Subd. 1. Type of data. The rightc of individual on whom the data is swred or to be swred shall be as set focth ia this section. Subd.2. Information required to be given individual. M individual asked to supply private or confidential data concecning himself shali be informed of: (a)the purpose and intended use of the cequesoed data M+idun du collecting State agency.political svbdivision,or sffitewide rystem; (b)whether he may refuse ot is lega(ly required to supply the requested data:(c)anY lmown conseque�e arising from his suPPIY�B or refusing to suPPtY private or confidential data;and(d)the identity of other persoas or entides authorized by state or fedeial law to c�eive the data. This requiremeat shall not apply when an i�ividual is asked to supp(y invesrigaave data,pursuant to secdon 13.82.subdivisioa 5,to a law enforcement officer. � The commissioner of revenue mav alace the nodce �ewired under this subdivision in the individual income taz or arooertv taz refund insaucdons instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individua!shall be informed whether he is the subject of stored data on individuals,and whether it is class�ed as public,private or confidential. Upon his further request,an i�ividuat who is the subject of stored private or public data on individuals shall be shown rhe data without any chuge 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 its meaning,the data need not be disclosed ro;him for six months thereafur unless a dispuu or acuon punvant w this secdon is pending or addiaonal data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon requat by the individual subject of the data. The responsible authority may require the requesting person W pay the actual costs of making,certifying,and compiling the wpies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or withia five days of the date of the request,ezcluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so infocm the i�ividual,and may have an addidonal five days within which to comply with the request,exciuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. M individual may contest the accurdcy or completeness of public or private data concerning himself. To exercise this right,an individual shall noafy in writing the responsible authority describing the nature of d�e disagreement. The responsible authoriry shall withia 30 days either. (a)correct the daca found ro be inaccurate or incomplete and aaempt w nodfy past recipiencs of inaccurate or incomplete data,including recipients nam�d 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 ic�luded with the disclosed data. The determination of the responsible authority may be appealed pursuanc to the provisions of the administradve procedure act reladng 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 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 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 full name is required to process this application or permit. First Middle Last Address . City State Zip Phone I understand my rights as stated above. Signaturo