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. � , <br /> l <br /> Sec.13.04 RIGFTTS OF SLTBJECTS OF DATA <br /> Subd. 1. Type of data. The righ�s of individual on whom the dara is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked w supply private or confidential data conceming himself shall <br /> be informed of: (a)the purpose and in[ended use of[he requested data within the collecting�tate agency,polidcal subdivision,or statewide sysum; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any I�own consequence arising from his supplying or refusing to supply <br /> privau or confidenaal dara;and(d)che idendry of other persons or enddes aurhorized by state or federal law to ceceive the dara. This requirement shall <br /> not apply when an individual is asked to supply investigadve dara,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax or vrouertv tax refund <br /> inscrucrions instead of on those forms. <br /> Subd.3. Access to data by indiridual. Upon requesc to a responsible authority,an individual shalt be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as public,private or co�dendal. Upon his further request,an individual who is the subject <br /> of storod private or public dara on individuals shall be shown the data wirhout any charge to him and;if he desires, shall be informed of the content <br /> and meaning of that data. After an individual has been shown ehe private data and informed of ics meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or action pursuant co this secdon is pending or addidonal data on the individual has been collected or crea[ed. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compiy with the requesc <br /> within that dme,he shall so inform the individual,and may have an addidonal five days wirhin which to comply with the request,excludiag Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or compiete. An individual may contest the accuracy or completeness of pubtic or private <br /> data concerning himse(f. To ezercise this right,an individual shall nodfy in writing the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shail within 30 days either: (a)correcc the data found to be inaccurate or incomplete and attempt to nodfy past recipiencs of <br /> inaccucate or incomplete�data, including recipients named by the individual;or(b)notify ihe individual thac he believes the data to be correct. Data <br /> in dispute shaii be disclo9ed only if the individual's statement of disagreemenc is included with the disclosed data. <br /> The determinarion of the responsibte authority may be appealed pursuant to[he provisions of the administradve procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your request <br /> for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you fumish will be used to determine your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the pemut or license. <br /> 3. The information may be shazed with other local, state or federal agencies to the extent necessary to process <br /> the permit or license. <br /> 4. If your requested pernut or license requires Council action to approve, some information may become <br /> public. <br /> 5, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> ,cl�� � f�i�s��— <br /> Fitst Middle Lasc <br /> ��/r�c� M7`��4 �d/t7 ��b � <br /> Ad ress . <br /> � /UNG�-��l� �l� �S�S—J ��v��� <br /> C�h, State Zip Phone <br /> I understand m rights as stated above. <br /> R <br /> Signa <br />