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�. � <br /> � <br /> Sec.13.04 RIGFTTS OF SUBJECTS OF D�TA � <br /> Subd. 1. Type of data. The righ�s of individual on whom the data is sroced or to be stored shall be as set forth in this secaon. - <br /> Subd.2. Information requIred to be givea iadividual. An individual asYed to supply private or confidenaal data concecning himsetf shall <br /> be informed of: (a)[he purpose aad inmaded use of the tequesc�dara withia the collecdng State agency,polideal subdivision,or scatewide rystem; <br /> (b)whe�her he cnay refuse or is legally�equired to supply�he tequesud daci;(c)any Irnown caasequence arising from his supplying or refusiag to supply <br /> privace or eonfidendal data;and(d)the idcndry of other persons or enodes auchorized by snte or fedeCal taw w receive the dars..This requirement shall <br /> not apply when aa individual is acked to supply invesriganve daa,pucsuane to secdon 13.82,subdivision 5.to a law enforcemeac ofricer. � � <br /> The commissioner of revenue mav olace che nodce r-auimd under rhis subdivision in the individual income tax or o�ooem taz refund <br /> inscrucdons inscezd oE on ehose focros. <br /> Subd.3. Accas to data bv indi►idual. Upon request to a responsible au�horiry,an individual shall be informed whe�her he is the subject � <br /> of stored dan on individuals,and whecher it is class�ed as pubtic,private or confidenaal. Upon his furchec request,aa individual who is the subjecc <br /> of scored private or public dara on individuals shall be showa ehe dara wichouc any charge to ti�m and;if he desires,shatl be infoaned of the content <br /> and meaning of chat data. Aher an individua!has been shown the private data and iaformed of its meanin3,the daa need not be disclosed to him for <br /> six monchs chereatter unless a dispute or acdon pursuant W[his secaon is pending or addidonal data on ehe individual hu been collected o�crea�ed. <br /> The responsibte auchoriry shaU pcovide copies of�he privace or public data upon nquest by che iudividu�l subjecc of et►e dard. The responsible auchoriry <br /> may require che requesdng peaon to pay the accual coscs of making,cecdfying,and eomp�7ing the copies. <br /> '!he responsible auchotiry shal!eomply immediacely,if possibte,wich any request made pursuant to this subdivision,or wi�hin five days of <br /> the dace of che request,exciuding Saturdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannot campty with the�quesc <br /> wirhin chac time.he shatl so inform che individual,and may have an addidonal five days wichia which m comply wich the requesc,exctuding Saturdays, <br /> Sundays and legal hotidays. <br /> I Subd.4. Procedure whea data is not accurate or eomplete. An individual may coatest the accuracy o�completeness of public orpri��ate <br /> dan concerning tiimself. To exetcise this right,an individual shall nodfy in wridng ette responsible auchoriry describing the nantre of the disagreement <br /> The responsible suchoriry shalt wichin 30 days eithec: (a)correcc the da�a found to be inaccan[e or iacomplete and attempc to nodfy pasc ncipiena of <br /> inaccurate or incomplete daca, inciuding recipieats named by che individual;or(b)aoafy ehe individual that he believes the data to be correcc Data <br /> in d'upute shall be disclosed only if the indir•idual's statemenc of disagre:ment is included wirh the d'uclosed dard. <br /> The dececminadon of the responsible auchoriry may be appealed pursuant to the provisions of the administrarive procedure act retadng to <br /> contated casts. <br /> DATA PRIVACY ADVISORY � <br /> In accordance with M.S. 13.04,Subd.2, "Righ,ts of subjects of data",we would like to inform you that your request <br /> for a permic or license from the Ciry of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. � <br /> You aze notified that:• <br /> 1. The information you furnish 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 Ciry deny the permit or Iicense. <br /> 3. The information may be shared wich ocher local, state or federal agencies to the extent 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 /> 5. You have certain rights under M.S. 13.04 (avaitable upon request) to review private data on yourself. <br /> 6. Your full name is required to process this application or permic. <br /> .�����T"� �`l �G P�,�,��' . <br /> F��� � Vfiddle Lasc <br /> Address � � �� � <br /> Ciry Sate Zip Phone <br /> I understand my rights as stated above. <br /> � <br /> Signature . <br />