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� <br /> . � <br /> Sec.13.04 RIGHTS OF SUB.TECTS OF D�TA <br /> Subd. i. Type of data. The righcs of individual on whom the data is stored or to be scored shall be as set forth in this secdon. <br /> Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenaal data concerning himself shall <br /> be informed of: (a) the purpose and in[ended use of the requested dara within the collecang'stace agency, political subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supp(y the requested data;(c)any lmown coasequence arising from his supplying or refusing to supply <br /> • priva[e or conndenda!data;and(d)the idenary of other persons or enriaes authorized by state or federal law to receive the data. This requirement stiall <br /> not apply when an individual is asked to supply invesdeaave dan, pursuant to secrion 13.82, subdivision 5, to a law enforcement o�cer. - <br /> The commissioner of revenue mav place che nodce reauired under this subdivision in che individual income tax or propertv tax refund <br /> instrucrions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon requesc to a responsible au[horiry,an individual shall be informed whethec he is the subjecc <br /> of scored data on individuals,and wherher ic is ctassified as public, private or confidenaal. Upon his further request, aa individual who is the subjecc <br /> of stored privace or public dara on individuals shall be shown the data wichouc any charge to him and, if he desires, shall be informed of the content <br /> and meaning of[hat data. Afrer an individual has been shown[he priva�e data and informed of iu meaning,the dara need not be disclosed to him for <br /> six monchs rhereafrer unless a dispute or acdon pursuanc to chis secdon is pending or addidonal data on the individual has been collzcced or crea[ed. <br /> The responsible authoriry shall provide copies of the private or public data upon requesc by the individual subject of the data. The responsible authoriry <br /> may require the requesring person to pay the accual cosu of makine,certifying,and compiling the copies. <br /> The responsible authoriry shali comply immediately, if possible, wirh any request made pursuant to this subdivision, or wirhin five days of <br /> the date of che request,excluding Sacurdays,Sundays and legal holidays,if immediace compliance is noc possible. If he cannot comply with the request <br /> within chac ticne,he shall so inform che individuai,and may have an additional five days within which to comply with the request,excluding Sarurdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individuat may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shall noafy in wricing the responsible au[horiry describing the nantre of the disagreement. <br /> The responsible authoriry shall within 30 days ei[her: (a)correct the data found to be inaccurate or incomplece and attempc to noafy past recipiencs of <br /> inaccunte or incomplete data, including recipients named by the individual; or(b) no[ify the individual[hat he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinarion of the responsible authoriry may be appealed pursuant to the provisions of the adminisa-aave procedure act relaang to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri;hts 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 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, but refusal may require that the City deny the permit or license. <br /> 3. The information may be shared with 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 certain rights under M.S. 13.04 (available upon request) [o review private data on yourself. <br /> 6. Your full name is required to process this applicacion or permit. <br /> �/�o��-s �r'.��r�s ��.��si <br /> First Middle Last <br /> Sg�s CJ ,�,e.���h� .�� <br /> Address <br /> /yl��.ze T.f�� Sr� /LloT- .s"s 3G �/ �/�� - SS�s� <br /> �ity State Zip Phone <br /> I understand my rights as s d abo e. <br /> Signacure <br /> � <br />