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i <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored 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 data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collect'3g torte agency,political subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any known i onsequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity of other persons or entities authorized by s e or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigative dam, pursuant to section 13 82,subdivision 5, to a law enforcement officer. <br /> The commissioner of revenue may place the notice required under this subdi.rision in the individual income tax or property tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authori ,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 data on individuals shall be shown the data without any charge to him and,'if he desires, shall be informed of the content <br /> and meaning of that data. After an individual has been shown the private data and info of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or action pursuant to this section is pending or add clonal data on the individual has been collected or created. <br /> The responsible authority shall provide copies of the private or public data upon request by a individual subject of the darn. The responsible authority <br /> may require the requesting person to pay the actual costs of making,certifying,and corn ifling the copies. <br /> The responsible authority shall comply immediately,if possible,with any requ st made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate co liance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days wi hin 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 y contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shall notify in writing the res Donsible authority describing the nature of the disagreement. <br /> The responsible authority shall within 30 days either: (a)correct the data found to be inn urate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is include with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to d a 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 dat %we would like to inform you that your request <br /> for a permit or license from the City of Orono or any of its departmeras 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 yoi <br /> qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may requirehat the City deny the permit or license. <br /> 3. The information may be shared with other local, state orderal agencies to the extent necessary to process <br /> the permit or license. <br /> 4. If your requested permit or license requires Council acon to approve, some information may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04 (available upen request) to review private data on yourself. <br /> 6. Your full name is required to process this application ot permit. <br /> ,7,t3.� <br /> First Middle Last <br /> 3!M0 -- <br /> Address <br /> City Stam Zip Phone <br /> I understand my rights as stated above. <br /> Signature <br />