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Sea13.04 RIGHTS OF SUBJECTS OF DaT.� <br /> Subd. 1. Type of data. The righa of individual on whom the data is s�:�3 or co be scored shall be as set focth in this secdon. <br /> Subd.2. Information reqirired to be given individual. An ir.dividua!ask�to supply private or confidendal data concerning himself shall <br /> be informed of: (a) the purpose and incended use of che cequesud data w:�in the collecring§tate agency,polidca!subdivisian,or sracewide sysum; <br /> (b)whecher he may refuse oY is legally required to supply che requested data:(c)any l�own coasequence arising from his supplying or refusing to supply <br /> privace or conndentiai data;and(d)the idendry of ocher persoa5 or enddcs a��horizrd by seace or federal law to receive the da[a..'Ihis requiremenc shall <br /> not appiy whan an individual is asked to supplv invesdgadve dara,pursu=:t to seccoa 13.83,subdivision 5, to a law enforcemeat o�cer. <br /> 'Ihz commissioner of revenue mav lace the nodce reouired er.der chis subdrvision in che individua! income tax or oro em cax reFund <br /> instructions instead of on chose forms. <br /> Subd. 3. Access to data by indiridual. Upon tequest to a responsible aethority,an iadividual shall be informed whe[her he is che subject <br /> of scored data on individuals,and whe[her it is classified as public,privac�or confidecrial. Upon his fur[her request,an individual who is the subject <br /> of scored privace or public data on individuals shall be shown che dara wi,;.out any c'"'�e to him and;if he desires, shall be informed of che concent <br /> and meaning of�hac data. Afttr an individual has been shown ehe priva:�Zac3 and iz:ormed of i[s meaning.the data need not be disclosed to him for <br /> six months[hereaiter uciless a dispute or acdon pursuant to this secdon is c:nding or addidoaal data on the individual has been cotlected or creaced. <br /> The responsible au�horiry shall provide copies of[he privace or public dac�a�on reques:by[he individual subject of ihe da[a. The responsible au[horiry <br /> may requir�the requesting petson to pay the actual costs of makin¢,cer ling,ar.d compiling the copies. <br /> The responsible authoriry shalt comply immediacely,if possible,wieh any r_quest made pursuant to this subdivision,or within five days of <br /> the dat-of tha rcques[,excluding Saturdays,Sundays and legal holidays,ii is.media�compliance is not possibte. If he cannot comply with the request <br /> wichin rhac time,he shai!so inform che individual,and may have an addicer3l five da:s wichin which to comply wi[h the request,ezcluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. an individuzl may contest the accuracy or completeness of public or pri�•ate <br /> dara conceming himself. To exercise chis right,an individual shall nodfy ia wridng c=responsibie authoriry describing che na�ure of the disagreemeac. <br /> The responsible auchoriry shall wichin 30 days eiche�: (a)correct the daa icund to be inaccucate or incomptece and aaempt to nodfy past recipienes of <br /> inaccurate or incomplete data,including recipients named by[he individi:xl;or(b) codfy the individual that he beiieves the data to be coaecc. Data <br /> in dispuce shall be disclosed only if the individual's statement of disagree�=nt is i.c:•_3ed with the disclosed data. <br /> The decerminarion of the rosponsibte auchoriry may be appeal=�punuanc to che provisions of�he admuuscrarive procedure act reladng to <br /> contested cases. . <br /> DAT?. PRIV?,CY AD��ISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri�hts of suojects of data", we would like to inform you that your reauest <br /> for a permit or license from the City of Orono or any oi irs deparments may require you to fumish certain private or <br /> confidencial information. <br /> You are notified that: <br /> 1, The informacion you fumish will be used to de:ermine}'our qualification for the permit or license requested. <br /> 2. You may refuse to supply data, buc refusal may require that the City deny the permit or license. <br /> 3, The information may be shazed wich other loczl, state or federal agencies to the excent necessary to process <br /> the permit or license. <br /> 4, If your requested permit or license requires Council action to approve, some information may become <br /> . . . . public. • <br /> �. You have cercain ri;hts under M.S. 13.04 (a�ailable upon request) to review private data on yourself. <br /> (, Your full name is required to process this aoolication or permit. <br /> � _ cz 1 - <br /> r'L <br /> First <br /> Vii e Last <br /> ... •� <br /> Addres } ����� ��.��''7'�� —�� / � — <br /> �-r , �� �ti1�. <br /> Stace Zip Phone <br /> Ciry <br /> I underst my rights as stated above. . <br /> �� <br /> Signacure <br />