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Sec.13.04 RIGFiTS OF SLJB.JECTS OF DaTA ' � Sutd. i. Type o[data. 'Ihe righcs of individual on whom the dara is s�orcd or ro be stoccd shalI be as sec forth in this section. • Subd.2. Iafarmation reqirired to be given indiridual. An individual asYed to supply privatt or coafidenrial dam concerning himself shaIl be inforu:ed of: (a)the purpose and inteaded use of the rtquesred dara wichin the eollacaag State agenty,poliacai subd.ivision,or sramwide rystm; (b)whe�er he may refuse or is.legally requir.d to supply che tequesud data:(c}any Iaiown eoasequence arising from his suppiyiag or refusing to supply privace orconnder.d31 dac�;az:d(d)the idendry of ocherpersoas orenddes aurhorized by srace or federal law to receive t�e data. This requiremenrshali not apply when an ir.dividual is asked to supply invesrigarive dara,pursuanc to secaon 13.82,subdivuion 5, �a taw enfarcement officer. 'I�a eeramissioner of rcvenue mav ntace the nodc- rauir.d under this subdivision in the individual income taz or orooem raz tefund inscructians insu_d of on[hose focros. Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whe[her he is ehe subj�cc of stor.d dacz on individuals,and whuher it is ciassifi�d as public, Privace or conF.denaal. Upan his funher r_quesc, aa individual who is the subjecc of stored privace ar public dara on individuaIs shall be shovm the dam wichout any charge to hun and;if he desires, shaII be informed of the eoatanc and meaning of[hat data. Afcer an individual his been shown the privare daca and informed of ics meaning,[he daca ne:d not be disclosed to him for siz monrhs�hereafcer unless a dispute or acdon punuanc to this secdon is ptnding or addidoaal data on the individual has been collectrd or ereaced. The cesponsible auehoriry shall providz copies of dte privac�or pubtic data upon request by the individual subject of the dam. Thz responsible authoriry may requir che requesring person to pay the accual cosu oi making,cerufying,and compiling che eopies. The responsib(e authoriry shall eomply immedia[ely, if possible,wich any request made punuanc to this subdivision,or wichin five days of the dare of�he requesc,excluding Saturdays,Sundays and legal holidays,if immedia�e compliance is not possible. If he cannot comply wids[he requesc wichin that ame,he shali so inform the individuai,and may have an addidoaaI five days within which to compiy wich the request,ezcluding Saturdays, Sandays and legal holidays. Subd.4. Procedure when data ts not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate data conceming himself. To exetcise this right,an individual shall nodfy in writing[he responsible au�horiry describing the nature of the disagreemeac. 'I�e�esponsible authoriry shall within 30 days eitt:er: (a)correct[ha data found to be inaccurate or incomplete and aaempt to norify past recipients of inaccura[e or incomplete data, including recipiena named by cht individual; or(b)nodfy the individua!thac he bdieves che daca to be correcG Dats in dispuce shall be disclosed only if the individual's statemen�of disagreement is includtd wich the disclosed data. The decerminaaon of che rtsponsiblc authoriry may be appealed pursuanc to the provisions of tha adminiscrarive procedure acc reladng to contesud cases. - DATA PRiVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�hts 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 deparcments may require you [o furnish certain private or confidential information. You are notified that: 1. "Ihe 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 Ciry deny the permit or license. 3. The information may be shared with ocher local, state or federal a�encies to the ettent necessary to process the permit or license. 4. If your requested permit or license requires Couacil action to approve, some information may become public. 5. You have certain ri�hts under h1.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this appiicatioa or permit. � l�G y`� �-v Yl ti. Firsc �fiddle Lasc 3�3°� ?5-�ti 1�� 5�, . Addreu �� V'Yl r� S5�i � � Ciry Snte Zip Phone I understand ri�hts as sca ed above. Signzcur