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Sec13.04 RIGHTS OF SUBJECTS OF DATA � Subd.l. Type of data. The rights of individual on whom the data is stor or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual ask to supply private or confidentiat daha roncernirtg himsetfstratt�-- informed oL• (a)t6e purpose and intended use of the requested data within tMe coll ting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)a�ny kn wn consequence arising from his supptying or refusing ta supply private or confidential data;and(d)the identity of ot6er persons or endHes authori by state or federattawtmeceive the - - not apply when an individual is asked to supply investigative date,pursuant tp secti n 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue ma lace thc notice rc uired unde this ubdivision in the individual income tax or ro ert tax refund instructions instead of un those forms. Subd.3. Access to data by individual. Upon request to a responsib auth rity,an individual shall be informed whether he is the subject of s ;and whether it is classified as public,private or co fiden al. Upon his further request,an individuatwtra istfiesnbjeei"af-^-'�s^!°"' " stored private or public data on individuals shall be shown the data without ahy cha ge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and info ed of its meaning,the data need not be disclosed to him for six —^�-molAfisthereafterunlessa-dispute�or$ctionpmsoanttorthi�ectiomspen ' d.�'he responsible authority shall provide copies otthe private or public data upon request b the individual subject ofthe dats.The responsible authority may _.._ �q�fR � �tertif�i , .. . . _ -- ---. -- The responsible authority shall comply immediately,if possible,with any r quest made pursuant to this subdivision,orwithin five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate co liance is not passible. If he cannot comply withShe request within that time,he shall so inform the individual,and may have an additional five days with which to comply with the request,excluding Saturdays,Sundays --- -a�fegat t�utidays. Subd.4. Procedure when data is not accurate or complete.An individual ay contest the accuracy or completeness of pubtic-ar private data --- .�7'uexereis�H►isright,an indivi[taal shall notify in writing Mre res ortsible authority describing the nature oftlte :;:-' responsible authority shall within 30 days either: (a)correct the data found to be i accurate or incomplete and attempt to notity past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)n tify the individual that he believes the data to be correct. Data in — onlx if theiodividuaPs statement of disagreement is includ d�itl�the disclosed data. The determination of the responsible authority may be appealed pursuan to the provisions of the administrative procedure act relaHng to �9ntCcted eacRc. -- --� ` DATA PRIVACY'AD ISORY ��- In accordance with M.S.13.04,Subd.2,"Rights of subjec s of ata",we would like to inform you that your request for a permit or license from the City of Orono or any of its d art ents may require you to furnish certain private or confidential information. You are nohfied that: � t. The information you furnish will be used to deterar►ine our qualification for the permit or 6cense requested: 2. You may refuse to supply data,but refusal may requi e that the City deny the permit or license. 3. The information may be shared with other local,state r federal agencies to the extent necessa�t�ps�ecess the permit or license. 4. If your requested permit or license requires Caunci action to approve, some information may ticcce�e public. 5. You have certain rights under M.S.13.04(available u on request)to review private data on yourself. 6. Your full name is required to process this application or permit. � � � �f � 11.7 a�,r .t� - - First Middle Last 0. .� a L •� � Address �� - m� �s�i y� �3 - �� City State Zip Phone I understand my ri hts as stated above. � Signature Reset Form I