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Sec.13.04 RIGHTS OF SUBJECTS OF DaTa <br /> Subd. 1. Type of daca. The rieh�s of individual oa whom the data is stored or to be scored shall be as se[fonh in this secdon. <br /> Subd.2. Information reqirired to be given indiridual. hn individual uked to supply priva[e or confidearial data concemiag himself shall <br /> be informed of: (a) the purpose and intended use of the requested dam within the collecang'state ageocy, polirical subdivision,or statewide system; <br /> (b)whecher he may refuse or is legally required to supply rhe requested data;(c)any Irnown coasequence arising from his supplying or refusing to supply <br /> � private or cortFdendal data;and(d)the idendry of other persons or enanes authorized by state or federal law to receive the data. This requiremeot sl�all <br /> no[apply when an individu�l is asked ro supply invesrigarive dara, pursuan�[o secdon 13.82, subdivision 5, to a law enforcement ofricer. - <br /> "I'he commission r of revenue mav olace the noace r�auired und�r this subdivision in the individual ir.come tax or prooem tax refund <br /> inscructions instead of on those forms. <br /> Subd. 3. Access to data by indi�idual. Upon request to a responsibte auchority,an individual shall be informed whether he is the subject <br /> of scored data on individuals,and whether ic is classified u public, private or confidenrial. Upon his further request,an individual who is the subjecc <br /> of scored privace or public dara on individuals shall be shown che dara wichouc any charge to him and,-if he desires, shall be informed of the con[enc <br /> and meaning of that data. Aher an individua!has been shown the privace data and informed of its meaning, the data need not be disclosed to hun for <br /> six mon[hs thereaiter unless a dispute or acdon pursuant to this secdon is ptnding or addirional data on the individual has been collected or created. <br /> The responsible authoriry shall p�ovide copies of�he private or public data upon requesc by�he individual subjecc of the data. The responsible auchoriry <br /> may require the requesring person to pay the accual costs of making, cettifying, and compiling the copies. <br /> The responsible authoriry shall comply immediacz(y, if possible, wich any requesc made pursuant to this subdivision, or wirhin five days of <br /> the da[e of the requesc,excluding Sacurdays,Sundays and le;al holidays,if immedia[e compliance is noc possible. If he cannoc comply with the reques� <br /> within that cime,he shall so inform[he individual,and may have an addiaonal Five days wi[hin which to comply wi[h the request,excluding Saturdays, <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 ezetcise[his rieht,an individual shall noa"ry in writing the responsible authori[y dtscribing the nacure of the disagreement. <br /> The responsibte aurhoriry shall wichin 3�days eicher: (a)correct the data found co bz inaccurace or incomplete and attempt to nodfy pasc recipiencs of <br /> inaccura�e or incomplece data, including recipien�s named by �he individual; or(b)nodfy che individual tha�he believes rhe data to be correcc. Data <br /> in dispute shall be disctosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determinadon of che responsible authoriry may be appealed pursuant ro the provisions of che admuiisaarive procedure act relacing 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 informa[ion you furnish will be used to determine your qualifica[ion for the permit or license requested. <br /> 2. You may refuse to supply da[a, but refusai may require that the City deny the permit or license. <br /> 3. The information may be shared wich other local, state or federal a�encies 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 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 perm.it. <br /> � � � �/� �Gc,��C�e� � <br /> First �Siddle Lasc <br /> ' ; /�. l'� .�' " %"(�"� <br /> Addre� �� <br /> r,� �~ � � C/ � C��—��� <br /> Ciry State Zip Phone <br /> I understand m '� t stated above. <br /> Sign re <br />