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� <br /> . <br /> � ` <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA f <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be�iven individual. An individual asked to supply private or confidential data concerning himself <br /> shall be informed of: (a)�e purpose and intetded use of the requested data within the collecting state agency,political subdivision,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or <br /> refusing to supply private or co�dential data;and(d)the identiry of other persons or enddes authorized by state or federal law to receive the dara. <br /> This requirement shal(not apply when an individual is asked to supply investigative data, pursuant to secdon 13.82, subdivision 5, to a law <br /> enforcement o�cer. <br /> The commissioner of revenue mav�lace the notice reauired under this subdivision in the individual income tax or orocertv tax refund <br /> instrucrions instead of on those forms. <br /> Subd. 3. Access to data by indlvidual. Upon request to a responsible authority,an individual shall be informed whether he is the <br /> wbject of stored data on individuals,and whether it is classified as public,private or confidendal. Upon his further request,an individual who <br /> is the subject of stored private or public data on i�ividuals shall be shown the dara without any charge to him and,if he desires,shall be informed <br /> 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 <br /> disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been <br /> collected or created. The responsible authority shall provide copies of the private or public data upon request by the individuat subject of the data. <br /> The responsible authoriry may require the requesting person to pay the actual costs 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 <br /> of the date of the request,excluding Saturdays,Sundays a�legal holidays,if immediate compliance is not possible. If he cannot comply with <br /> the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with ihe request, <br /> excluding Saturdays,Su�ays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An uidividual may contest the accuracy or complcteness of public or <br /> private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the <br /> disagreement. The responsible authority shall within 30 days either: (a)correct the dala found to be inaccurate or incomplete and aaempt to nodfy <br /> past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)nodfy the individual that he believes the data <br /> w be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinadon of the responsible authority may be appealed pursuant to the provisions of the administraave procedure act relating <br /> to 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 <br /> request for a permit or license from the�ity of Orono or any of its departments may require you to furnish certain <br /> private or 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 <br /> requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. <br /> 3. The information may be shazed with other local, state or federal agencies to the extent necessary to <br /> process 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(available upon request) to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> �s��F-, S�-� f`�=� Z .. <br /> First Middle L.ast <br /> �7(� E�M �o� <br /> Address �Z - 72.— Ss}7 }{ <br /> ��am�0 �V� �S3f� � �2 3�3 -�?�S� w <br /> Ciry State Zip Phone <br /> I understand my rights as state above. <br /> ignawre � <br /> 6 <br />