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� <br /> -� <br /> . � <br /> Sec.13.Oh RIGHTS OF SUBJECTS OF D�TA <br /> Subd. 1. Type of data. The rizhrs of individual on whom the data is srored or co be stor.d shall be as set forth in this secaon. _ <br /> Subd.2. Iuformation reqtrired to be given individual. An individual asked to supply priva�e or confideaaal data concemiag himself shall <br /> be informed of: (a) the purpose and incended use of che reques�dara wichin tho eollecdng State ageacy, polidcal subdivision,or sca�ewide ryscem; <br /> (b)whe�her he may rfuse or is legally requir.d to supply the requuted da3;(c)any lrnown coasequence arising from his supplying or refusing to supply <br /> privace orconndendal dzra;ar.d(d)the ideadry of other parsons or enddes auchorized by sc�te or federal law to receive tha daca. This requ'uement shalt <br /> not apply when an individuai is asked to suppiy invesrioarive dam,pursuanc to secdon 13.83,subdivision 5, to a law enforcemeat ofrccer. - <br /> '[he commissioner of revenue mav place che noace rauird undar�his subdivision in the individual income mx or orooem ax refur.d <br /> inscrucdons inscead oE on chose forms. <br /> Subd. 3. Access to data by indir-idual. tipon requcst co a cesponsible auchority,an individual shall be inforrued whe�her he is the subject � <br /> of scnr.d dara on individuals,and whecher ic is class��d as pubiic, privace or confedenaal. Upon his furcher requesc,an individual who is the subject <br /> of stored privace or public dara on individuals shail be shown ch�data wichouc any charge to tiim and;if he desires, shall be infoaned of the contznt <br /> and meaning of chat dara. Aher an individual h�s been shown the privac:data and infonned of ics meaaing,the data need not be disclosed to him for <br /> siz mon�hs thareaiu.r uriless a dispute or acdon pucsuant to this secdon is pending or addidoaal data on the individual has beea collecced or creactd. <br /> The r:sponsibl�authoriry shall p�ovide copies of the privace or public data upon requcsc by che individual subjccc of the daca. Tne responsib(e auchoriry <br /> may tequire the tequesang person to pay the accual cosu of making,cerafying,and compiling the copies. <br /> The responsible auchorry shall eompiy immedia[ely,if possible, wich any requesc made pursuant to this subdivision,or wi�hin ftve days of <br /> the dace of th�request,exciuding Sa�urday5,Sundays and legal holidays,if immzdiate compliance is not possible. If he cannot comply wich the requesc <br /> within chat time,he shall so inForm the individual,and may have an addirional five days wi[hin which to comply wich the requesc,exciuding Saturdays, <br /> Sundays ar.d legal holidays. <br /> Subd.4. Procedure Khea data is not accurate or complete. An individual may contesc the accuracy or completeness of public or private <br /> daca conc:ming hir.iself. To exercise this ri¢hc,an individual shall nod"ry in wriang che responsible auchoriry describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correc�the data found to be inaccurate or incomple�e and aaempt to nodfy pasc recipientt oF <br /> inaccurace or incomplece data, including recipiencs named by�h:individ�al;or(b)noufy the individual that he believes che data to be coaecG Data <br /> in dispute shail be disclosed only if the individual's sc�tement of disagr:ement is incladed with the disclosed data. <br /> 'Ihe de�erminadon of the responsible authoriry may be appea(ed pursuant to the provisions of the adminisaarive procedure act relaan� to <br /> contesced cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance wich M.S. 13.04, Subd.2, "Ri�hts of subjects of data", we would like to inform you that your reques[ <br /> for a perrrut or license from the Ciry of Orono or any of its departments may require you to fumish certain private or <br /> confidential informacion. <br /> You are notified thar.- <br /> 1. The information you furnish will be used to determi.ne your qualification for the permit or license requested. <br /> 2. You may refuse [o supply data, buc refusal may require that the City deny the permit or license. <br /> 3. The information may be shared with ocher local, state or federal a�encies to the excent necessary to proeess <br /> ' the permit or license. <br /> 4. If your requesteci permit or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain riQhts 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 perm.ic. <br /> �,� �_ ,' l��(�� <br /> First �1' dle y Las� <br /> t �� �I �L,Lx�r�'1/✓�L ��i/��� ��l� <br /> . <br /> Addre�»r� ��/i1� 5'S��1 �%%--� z�� <br /> Ciry Srate Zip Phone <br /> I understand my ri� s s ted � <br /> Signature <br />