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. <br /> Sec.13.04 RIGH'TS OF SUBdECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom[he data is stored or to be scored shall be as set fotth ia ttus secdon. <br /> Subd.2. Information reqirired to be given individual. r1n individual asked to supply private or confidendal data conceming himself shall <br /> be informed of: (a)che purpose and inrended use of the requested dara wichin the collecting Ytate agency,polidcal subdivision,or sratewide sysum; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any lrnown consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the idenrity of other persoac or enrides auchocized by state or federat law to rcceive the data. This requirement shall <br /> not apply when an individuai is asked to supply invesdgadve dare, pursuanc[o secdon 13.82,subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue mav place the nodce rowired under this subdivision in the individual income tax or propertv tax refund <br /> instcuctions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whe[her ic is class�ed as public,priva�e or confidendal. Upon his further requesc, an individual who is the subject <br /> of stored private or public data on individuals shall be shown che data wi[houc any charge to him and, if he desires, shall be informed of the contenc <br /> and meaning of�hat data. Afur an individual has been shown the privare data and informed of its meaning,the dara need not be disclosed to him for <br /> six months theroaftec unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible au[horiry shall provide copies of the private or public data upon requesc by the individual subject of ihe dara. The responsible authoriry <br /> may require the requesdng person to pay the actual costs of making,cerdfying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,wirh 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 comply with the request <br /> within that time,he shall so inform the individuai,and may have an addidonal five days within which co comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is aot accurate or complete. An individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individuai shall nodfy in wridng the responsible authoriry describing[he nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)cornct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)nodfy the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed dara. <br /> The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminisuadve procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Riehts of subjects of data",we would like to inform you that your request <br /> for a pemut or license from the City of Orono or any of its departments may require you to fumish certain private or <br /> confidential information. <br /> You aze notified that: <br /> i, 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 City deny the pemut or license. <br /> 3, The information may be shared with other 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 (available upon request) to review private data on yourself. <br /> 6, Your full name is required to process this application or permit. <br /> First ��d� Midd�e ��j��`,(/,!/D <br /> /�/` !/ <br /> Address � �� ��GLfi i��i� -''`� �6�� ./ i /l / 7` /` m�r�� <br /> City State Zip Phone <br /> I understand rights as st ed abov . <br /> `�,y� <br /> Signature <br />