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Sec.13.Q4 RIGF3TS OF SUBJECTS OF DATA ' <br /> Sabd. 1. Type o[data. The righcs of individual on whom the data is stored or ro be stnrd shalI be as sa forth in this section. <br /> Subd.2. Iatormaton required to be givm indiridual. �n individual uYed w supply privart or confideadal dam eoncerning himself shaIl <br /> be infocmed o`: (a)tfie purpose and intended use oE the requurai dam withia the eollecung State ageury.polirical subdivision,or sca�ewide rys��; <br /> (b)whec�er he tray reEuse oY u.legally tequir.d co suppty the rquesud dsa:(c}aay laiown caastqucnce arising from his supplyiag or refusing eo supp[y <br /> p;iva�e or con::der.aal dara;ar.d(d)tk�e ideadry of a�her persoas or enodes auc�orized by sc�te or federal law to tr�eive ehe da[a. 'Ihis requirement shall <br /> no[apply wren an ir.dividual is asked to supply invesrigadve dan,pursuaac ca s<cdan 13.82,subdivision 5,co a[aw enforcemenc oFficer. <br /> '[he ee:lmissionec of rcvenue mav otace the noace r_auir.d under this subdivision in the individual incorrte nz or orooecrv t�z refund <br /> instrucdons inscead oE on chose fomu. <br /> Subd.3. Access to data by iadiridual. Upon requesc to a responsibie auchoary,an individual shall be informed whaher he is che subjecc <br /> of stnr_d dan on individuals,and whethe�it is classifi:d u public,private or conF.denaal. Upoa his furcher r_quest,aa individual who is the subje:c <br /> of s:or_d priva;e or pubtic dara on individaais shall be shown che daa wichout any eharge to him and;if he desira,shall be infocmed of the eoatenc <br /> aad m:aning of that daa. Afre�an individual has been shown che private dati and informed oC ict meaaing,the daca nerd not be disclosed oo him fo� <br /> six monchs theceafu�unless a dispute oc acQon pursuanc to this secdon is peadiag oc addidoaal dac�on the individual h�been eollected or erea`d. <br /> The responsibie aud:oriry shall�provida capies of che priva�orpublic dara uFon request by che individual subjecc of che dara. The respansible au�hociry <br /> may require the requesdng person ro pay the accual coscs o;maki�g,cecafying,and eompiling che copia. <br /> The responsible authoriry shall eomply ir,ur.edia�zly,if possible,wich any request made pursuant co chis subdivision,or wichin five days of <br /> the dace of�he requesc,excluding Sacucdays,Sundays and legal holidays,if immediaca compliaace is no�possible. If he canaot comply wich the requesc <br /> wichin that dcne,he shal!so inform[he individual,and may have an addidoaai five days within which to comply wich the request,excluding Sacurdays, <br /> Sundays and legal holidays. . . <br /> Subd.4. Procedure when data is not accurate or complete. An icdividual may eonc:st rhe accurdcy or compieceness aFpublic or priva�e <br /> dara conceming tiunself. To ezercise chis right,an individual shall noafy in wridng ehe nspocuible auchoriry describing the nature oF the d'uagreemeac <br /> The responsible authoriry shall within 30 days eitl;cr: (a)correct�he data found to be inaccurdte oc incomplete aad aaempc to nodfy past recipiencs of <br /> inaccutato or incamplete data, including rccipien�s named by che individuat;or(b}noafy the individual that he bclieves the dara to be correcG DaCi <br /> in dispuce shal!be disclosed only if the individLa!'s scater,.en�of disagreement is included with tht d'uclosed data. <br /> The decerminadon of the responsibta auchoriry may be appealed pursuanc to the provisions of[ha adminisaarive procedure acc relaring to <br /> eonteswd eases. • <br /> DATA PRIVACY ADVISORY <br /> In accordance wich M.S. 13.04,Subd.2, "Ri;h�s of subjeccs of data", we would like to inform you tha[your request <br /> for a pemuc or license from the Ciry of Orono or any of ics deparcments may require you to furnish certain private or <br /> confidential information. <br /> You aze notified that: <br /> 1. The infocmation 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 license. <br /> 3. The information may be shared wich o�her local, s�ace or federal a�encies to the etcenc necessary to process <br /> the permit or license. <br /> 4. If your requested perm.it or license requires Council action to approve, soaie information may become <br /> public. . <br /> 5. You have certai.n rights under M.S. 13.04 (availabie upon reqnest) to review private data on.yourself. , <br /> 6. Your full name is required to process this application or perm.it. <br /> -_, � �� <br /> � k � <br /> ;�.� �'�c, � � ��� �� ��� <br /> Firsc �tiddle I.asc <br /> �-���-,� ��� ��-� ��U <br /> � - <br /> �,da�u ,� \ <br /> L�� L"�-�� . \Y,��ti ��� `� J� `,�� � -�__ <br /> Ciry " Snce Zip Phaae <br /> I understan �aiy rig .s as stat above. <br /> , ��� . <br />