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� <br /> Sec.13.0.1 RIGHTS OF SUBJECTS OF D:�TA <br /> Subd. 1. Type of daca. "Ihe riehrs of individual on whom[he data is stored or to be scored shall be as set fonh in this secrion. <br /> Subd.2. Information reqirired to be given indi�idual. An individual asked to supply privace or confideodal dara coacerning himself shall <br /> bz informed of: (a)the purpose and incended use of che requesred dara within the collecdng"stat�ageacy, polidcal subdivisioa, or sracewide rystem; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any�own consequence arising from his supplying or refusing to supply <br /> � priva[e or confidenrial data;and(d)the idendry of orher persoas or enriries aurhorized by state or fzderal law ro receive the data. This requirement shali <br /> noc apply when an individual is asked to supply invesrigadve dam, pursuan�to secdon 13.82, subdivision 5, to a law enforcemenc ofricer. - <br /> The commissioner of revenue mav lace tha nodce reauired under this subdivision in the individual ir.come tax or orooem tax refund <br /> insrrucdons inscead of on chose forms. <br /> Subd. 3. Access to data by indi�idual. lipon reques[to a responsible auchoriry,an individual shall be informed whe[her he is the subject <br /> of scored data on individuals,and whe�her it is classified as public, privace or confedendal. Upon his further request, an individual who is the subjecc <br /> of stored privace or public dam on individuals shall be shown che dara wichout any charge to him and,-if he desires, shall be informed of the content <br /> and meaning of rhac data. Aher an individual has been shown[he priva�data and informed oE iu meaning, the data need not be disclosed to him for <br /> six mon�hs thereafter unless a dispute or acaon pucsuant co [his secaon is pending or addidonal data on the individual has beea coflecced or creaced. <br /> The responsible aurhoriry shall provide copies of che privace or public data upon request by rhe individual subjec�of[he data. The responsible auchoriry <br /> may require[he requesring person to pay the accual costs of making, cerufying, and compiling the copies. <br /> The responsible authoriry shall comply immediacely, if possible, with any reques�madz pursuant co this subdivision, or wi�hin five days of <br /> the dace of the requesc,exciuding Sanirdays,Sundays and legal holidays,if immediace compliance is no�possible. If he cannot comp(y wich the requesc <br /> wi[hin that time,he shall so inform the individual,and may have an addirionai Five days within which to comply with[he request,excluding Sacurdays, <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 /> data concerning himselF. To exercise chis riehc,an individual shall nodfy in wriang rhe responsible authoriry describing the nacure of che disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correcc[he da�a found to be inaccurate or incomplete and attempt to noafy pasc recipients of <br /> inaccurate or incomplete data, including recipien�s named by che individual; or(b)noriFy the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statzmene of disa�reement is included wi[h the disclosed data. <br /> The decerminarion of thz rzsponsibte authoriry may be appzaled pursuanc to the provisions of the administrarive procedure act reladng to <br /> contesced 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 tha[your request <br /> for a pernut or license from the Ciry of Orono or any of its departments 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, buc refusal may require that the City deny the perm.it or license. <br /> 3. The information may be shared wich 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 cercain riohts 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 /> --� <br /> l���. ,J���� t`��„t-t <br /> � <br /> First Middle Last <br /> �S� T�l'�:� �?��f� C`���.— �s-sa�� ���z���� �'�li��. <br /> Address <br /> � z � <br /> �����%z���. 6��'�L' �-;�3 �( Y?S�-r <br /> Ciry State Ztp Phone <br /> I understand my �hts as stated above. ,� <br /> c, ,� � <br /> � J <br /> � /� � / <br /> � <br /> Signamre <br />