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Scc.13.0�1 RICF(TS OF SUBJECTS 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 foRh iii this section. , <br /> Subd.2. Information required to be given individual. An individual asked to supply private or contidential dataconceming himselfshall be <br /> informed of: (a)the purpose and intended use ofthe requesced data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is le�ally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shal I <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav place the notice required�mder this subdivision in the individual income tax or�rooerry ta�refund <br /> instructions instead of on those fonns. <br /> 5ubd.3. Access to data by individual. Upon request to a responsible authority,an individual shail be informed whether he is the subject of <br /> stored da[a on individuals,and whether it is classitied as publ ic,private or contidential. Upon his further request,an individual who is the subjcct of <br /> stored private or public data on individuals shall be shown the data�vithout any charge ro him and,if he desires,shaU be inFonned ofthe content and <br /> meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed ro him for six <br /> months thereafter unless a dispute or action pursuan[to this section is pendine or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the private or publ ic data upon requesc by the individual subject of the data. The responsible auchority <br /> may require tl�e requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of <br /> the date ofthe request,excluding 5aturdays,Sundays and legal holidays,if iinmediate compliance is not possible. [f he cannot coinply with the request <br /> within that time,he shal I so inYonn the individual,and may have an additional tive days withiii which to comply with the request,escluding 5aturdays, <br /> Sundays and leoal holidays. <br /> 5 ubd.4. Procedure�vhen data is not accurate or complefe. An individual may contest the accuracy or completeness ofpublic or private data <br /> concernin�himself. To exercise this right,an individual shali notity in�vriting the responsible authority describing the nature of the disagreement. The <br /> responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notif�•past recipients of <br /> inaccurate or incomplete data,induding recipients named by the individual;or(b)notity[he individual that he believes the data to be correct. Da[a in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with[he 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 inforn�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 /> l. The information you furnish will be used to detern�ine 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 oc license. <br /> 3. The infonnation 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 infornZation may become <br /> public. <br /> 5. You have certain rights under MS. 13.04 (availablz upon request)to review private data on yourself. <br /> 6. I'our full name i requir d to rocess this application or pemiit. <br /> � ��l ,- <br /> First �diddic ,� \Last <br /> , �� � ; �� �� /�� ��� <br /> Address <br /> � �; � ;�,�/ __`���� /� <br /> V� <br /> CiIF SiAic %iP i'i0��e <br /> I understand m� rirhts as st d above. <br /> ! --_.. <br /> Sign;�turc <br /> Reset Form �'' <br />