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Sec.13.0�RIGHTS OF SUBJECTS OF DaTA <br /> Subd. 1. Type of data. The riehcs of individual on whom the data is scored or to be stored shall be as sec fotth in this secdon. <br /> Subd.2. Informatioa reqirired to be given indiridual. An individual asked to supply privace or confideodal daca concerning himself shall <br /> be informed of: (a) the purpose and inrended use of the requested data withia the collecang'state agency,polidcal subdivision,or statewide rystem; <br /> (b)whecher he may refuse oY is legally required co supply che requested data;(c)any Irnown consequence arising from his supplying or refusing to suppty <br /> priva�e or conndential data;and(d)the idenrity of o[her persons or enrities au�horized by state or federal law to receive the data. This requiremenc shall <br /> noc apply whzn an individual is asked to supply invesri¢aave dara, pursuanc to secdon 13.82, subdivision 5, [o a taw enforcemenc o�cer. <br /> The commissioner of re�enue riav place the norice reauired under this subdivision in the individual income tax or propem tax refund <br /> inscructions inscead of on chose forms. <br /> Subd. 3. Access to data b�indirzdual. Upon requesc co a responsible auchoriry,an individual shall be informed whether he is the subject <br /> of scored data on individuals, and whe[her it is ciassified as public, privace or confidendal. Upon his further request, an individual who is the subjecc <br /> of scored private or public data on individuais shall be shown che data wichout any charge to hirn and,�if he desires, shall be informed of the concenc <br /> ar.d meaning of chat daca. After an individual has been shown[he privace data and informed of irs meaning,the data need not be disclosed to hirn for <br /> six monchs therearcer unless a dispute or acrion pursuanc to [his secrion is pending or addidonal data on the individual has been collecced or creaced. <br /> The responsible auchoriry shall provide copies of the priva[e or public data upon request by the individual subject of[he daca. The responsible authoriry <br /> may require�he requesring person to pay the actual costs of making, cerafying, and compiling the copies. <br /> The responsible au[horiry shall comply immediately, if possible, wich any request made pursuant to this subdivision,or wichin five days of <br /> the date of[he requesc,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesc <br /> wi�hin chac time,he shail so inform�he individual,and may have an additional five days within which to comply wi[h the request,excluding Saturdays, <br /> Sundays and legai holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may concest the accuracy or completeness of public or pri�•ate <br /> dara conceming himself. To exercise this ri¢h[,an individual shall nodfy in wriring the responsible authoriry dzscribing[he nature of the disagreeme�t. <br /> The responsible auchoriry shall within 30 days ei[her: (a)correct the data found to be inaccu�a[e or incomplece and attempc to norify past recipienu of <br /> inaccurace or incomplete data, inciuding recipiencs named by [he individual:or(b)notify the individual thac he believes the data to be correct. Data <br /> in dispu�e shall be disclosed oniy if the individual's sta[ement of disagreement is included with the disclosed data. <br /> The de�erminarion of che responsible auchoriry may be appealzd pursuanc to che provisions of the administrarive procedure act relaang 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 reauest <br /> for a permit or license from the Ciry of Orono or any of its depar[ments 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 deternune 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 pemut or license. <br /> 3. The information may be shazed wi[h other local, state or federal a;encies to the extent necessary to process <br /> the pemrit or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> �. 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 /> First vfiddie Lasc <br /> Address <br /> Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> � , j., ,. <br /> ,; � i�., <br /> f�' � C_1 L.,v. . �� �/- V <br /> � , ; ���. <br /> , � <br /> Signature �. <br />