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04/18/2006 09:03 FAX 612 746 5505 BENESYST 1�005 <br /> ... • � � <br /> Sec.13.04 RIGATS OF SUBJECfS OF DATA <br /> Subd.l. Type of data The rights of individual on whom the data is stored or to be sto7ed shall be as set forth in this section. <br /> 5ubd.2.Information requircd to be given individual.An individual asked to supply private or confidential data concerning himselfshal]be <br /> informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required W supply the requested data;(c)any knowa consequence arising from his supplying or refusing to supply <br /> private ar confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This�equirement shall <br /> not apply when en individual is asked to supply investigative data,p�usuant to section 13.82,subdivision 5,to a Iaw enforcement officer. <br /> The commissioner of revenue mev place the notica required ander this subdivi�ion in the individual income tax or oronertv tax refund <br /> instructions instead of on those fortns. <br /> Subd.3.Access to data by individual. Upon requestto a responsible authority,an individual shall be informed whetherhe is the subject of <br /> stored data on individuals,and whether it is classified as public,private orconf dential.Upan his further requesS an individual who is the subjec[of <br /> stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and <br /> meaning of that data. ARer an individuai has bean shovm the private deta and informed of its meaning,the data need not be disclosed W him for six <br /> monfhs thereaRer unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the private or public data upon requost by the individual subject of the data_ The responsible authority <br /> may require the requesting person to pay the actual costs of ineking,certifying,and compiling the copies. <br /> The rasponsible authority shall comply immediately,ifpassible,with any request made pursuant to this subdivision,or wiffiin five days of <br /> tha date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compl ience is not possible.If he cannot comply with the request <br /> within that time,hc shall so inform the individual,and may have an additionaf five days within whichto comply with the request,excluding Sarordays, <br /> Sundays and legai holidays. <br /> Subd.4.Procedure when data is not accurate or complete.M individua!may contestthe accuracy or completeness ofpublic or private data <br /> conceming himself.To exercise this right,an individual shall notify in writing tha responsible authority describing the nature ofthe disagreement.The <br /> responsible authority shall within 30 days either: (a)correct the dara found to ba inaccurate or incomplete and attempt W notify past recipients of <br /> inaccu�ate or incomplete data,including recipients nemed by the individuai;or(b)no4fy the individual that he believes the detato be correct Data in <br /> dispute shall be disclosed anly if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administretive procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S.13.04,Subd.2,"Rights ofsubjects 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 <br /> 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 <br /> process 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. I3.04(available upon request)to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> mazk �,�, gaylord <br /> First Middle ��� <br /> 182 2nd st <br /> Address <br /> excelsior � 55331 (612)720-1547 <br /> C�h' State Zip Phooe <br /> T understand my right as stated a ve. <br /> �- l� - z�o,� <br /> Sigoat re <br /> 32 <br />