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w <br /> Sec.13.04 RIGHTS OF SLJBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, political subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential dara;and(d)the idendry of other persons or enddes authorized by state or federal law to receive the data. This requirement shall <br /> not apply wher.an individual is asked to supply invesdgaave data, pursuan[to section 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propertV tax refund <br /> instructions instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible au[horiry,an individual s'�all be informed whether he is the subject <br /> of stored data on individuals, and whether it is classified as public, private or confidenrial. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data without any charge to hirn and, if he desires, shali be informed of the content <br /> and meaning of Lhat data. After an individual has been shown the private data and informed of ia meaning, the data need not be disclosed to him for <br /> six months[bereafter unless a dispute or action pursuant to this secrion is pending or additior.a!data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the actual cosu of making, cercifying, and compiling the copies. <br /> The responsible authoriry shall comply immediately, if possible, with any request mad�pursuant to this subdivision, or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he can�ot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,exciuding 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 conceming himself. To exercise this right,an individual shall notify in wridng the responsible authority describing the narure of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomple:e and attempt to notify past recipients of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b)no[ify the individual that 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 determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 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 /> con�dential 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 da[a, but refusal may requi;e 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 full name is required to process this application or permit. <br /> !�/l�lb�n�l �, r�� Ga/Gn> �� <br /> � <br /> First Middle Last <br /> � �(1L%l �� S l 1 D <br /> Address <br /> �-frPhi�� r��- =ss-3��i 9-� �--�5�'6 <br /> City State Zip Phone <br /> I understand my rights as stated above. <br /> U � �� � �� - _ � <br /> Signamre %� <br />