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4 <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the dam is stared or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential dam concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecting State agency,political subdivision,or smtewide system; <br /> (b)whesher he may refuse of is legally required to supply the requested dam:(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.,This requirement shall <br /> not apply when an individual is asked to supply investigative dam,purse=-t to section 13.82,subdivision S, to a_law enforcement officer. <br /> The commissioner of revenue may place the notice rewired order this subdivision in the individual income tax or oroyerty tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject <br /> of stored private or public dam on individuals shall be shown the dam wiu.out any charge to him and;if he desires,shall be informed of the content <br /> and meaning of that dam. After an individual has been shown the privato dam and informed of its meaning,the dam need not be disclosed to him for <br /> six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. <br /> The responsible authority shall provide copies of the private or public dam ucon request by the individual subject of the dam. The responsible authority <br /> may require the requesting person to pay the actual costs of making,cc-- ing,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible.with 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 individual,and may have an addideral five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private <br /> dam concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the dsagrement. <br /> The responsible authority shall within 30 days either: (a)correct the dam found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete dam, including recipients named by the individt:al:or(b)notify the individual that he believes the dam to be correct. Dam <br /> in dispute shall be disclosed only if the individual's statement of disagree-ent is included with the disclosed dam. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to <br /> 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 request <br /> for a permit or license from the City of Orono or any of its deparments may require you to furnish certain private or <br /> confidential information. <br /> You are 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 City deny the permit or license. <br /> 3. The information may be shared with other loci, 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 /> f Ztc64AA,,,, w wAGtil <br /> First Middle Last <br /> Address <br /> L-6 gr, 1-.4 k C-' SS 3 3L <br /> City State Zip Phone <br /> I understand my rights as stated above. <br /> Signature <br />