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� <br /> 5ec.13.04 RIGHTS OF SIIB.TECTS OF DATA <br /> Subd. 1. Type oE data. The rights of individual on whom the data is stored or to be scored shall be as set forth in this secrion. <br /> Subd.2. Informadon reqirired to be given individual. An individual asked to supply private or confidendal dara conceming himself shall <br /> be informed of: (a) the purpose and intended use of the r�quesied data wirhin the collecang"state ageocy, polidcal subdivision,or sratewide system; <br /> (b)whecher he may refuse oi is legally required co supply the requested data;(c)any lrnown coasequence arising from tus supplying or refusing to supply <br /> • priva[e or confidential data;and(d)the idenary of other penoas or endaes auchorized by state or federal iaw to receive the data. This requirement stiall <br /> not apply when an individual is asked to supply invesrigadve dan, pursuant ro secdon 13.82, subdivision 5, to a law enforcement o�cer. - <br /> The commissioner of revenue mav place the noace reauired under[his subdivision in the individual income tax or propertv tax refund <br /> instrucdons instead of on those forms. <br /> Subd. 3. Access to data by indiridual. Upon requesc to a responsible auchority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whe[her ic is classified as public, privace or confidenrial. Upon his further request,an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown[he data wichout any charge to him and,�if he desires, shall be informed of the concent <br /> and meaning of[hac data. Afrer an individual has been shown che privace data and informed of ics meaning, the data need not be disclosed to him for <br /> six mon�hs thereafrer unless a dispute or acdon pursuanc to this secrion is pending or addidonal data on the individual has been cotlected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon requesc by the individuai subjecc of che data. The responsible authoriry <br /> may require the requesring person to pay the actual costs of making,cerrifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within 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 /> within chac time,he shall so inform[he individual,and may have an addidonal five days within 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 individuaf may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise�his right,an individual shali noafy in writing the responsible au[horicy describing the nanire of the disagreemenc. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomple�e and attempt to noafy pasc recipients of <br /> inaccurate or incomplete data, induding recipiena named by the individual; or(b)noafy the individual that he believes rhe data to be correcc. Data <br /> in dispute shall be disclosed only if the individual's statemenc of disagreement is included with che disc(osed data. <br /> The decerminaaon of the responsible authoriry may be appealed pursuant to the pcovisions of the administrative 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 that your reques[ <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 pemut 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) to review private data on yourself. <br /> 6. Your fu11 name is required to process [his application or permit. <br /> ��Ah�°�'� �4 iJ� ��`��'.� <br /> First Vtiddle Lasc <br /> �}-7� �en;z'�,J`� <br /> Addres f <br /> �� � f��� �v..�,�� ��>`�-`v��� <br /> Ciry' State Zip Phone <br /> I unde d my ri�hts as stated above. <br /> �, � ` , <br /> Signatur <br />