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Sec.13.04 RIGHTS OF SL'B.TECTS OF D�T�; <br /> Subd. 1. Type of data. �he riehts oi individual on whom[he data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be�ven indi�idual. :�n individual asked[o supply private or confidenaal dara concerning himself shall <br /> be informed of: (a)the purpose and in�ended use o[the requested da[a wi[hin the collecang'siate agency, polidcal subdivision, or statewide system; <br /> (b)whecher he may refuse or is legally required to supply che requesced data;(c)any known consequence arisine from his supplying or refusing to supply <br /> private or contidennal data;and(d)the idendty of other persons or endnes au[horized by state or federal law to receive the data. This requirement shall <br /> no[apply when an individual is asked to supply invesdgaave data, pursuan�to secnon 13.82, subdivision�, to a law enforczment officer. <br /> The commissioner of re�erue r�a� olac 7 rodc r auir�d unde- this subdivision in the individual income �z or oropem tax refund <br /> instructions instead of on chose forms. <br /> Subd. 3. ?.ecess to data by individual. lioon requesc to a responsible authoriry,an individual shall be informed whecher he is the subjec[ <br /> of stored data on individuals, and whe[her i[is classitied�s puolic, pnva[e or conridennal. Upon his funher request,an individual who is[he subject <br /> of stored private or public data on individuals shall be shown [he daca wichouc any charge to him and, if ne desires, shall be informed of the co�[ent <br /> and meaning of thac data. �Rer an individual has been shown[he private data and informed of its meaning, the data need not be disclosed to hun for <br /> six mon�hs thzreatier uriless a dispute or acaon pur5uanc co this secnon is pending or addinonal data on the individual has been collected or created. <br /> The responsible au[honry shall provide copies of the pri�ate or public daca upon request by the individual subject of the data. The responsible au[hority <br /> may require the requesting person to pay the actual costs of making, ceitifying, and compiling the copies. <br /> The responsible authority shall comply immediately, if possibfe, with any request made pursuant to this subdivision, or within five days of <br /> the date of the request,excluding Sa[urdays,Sundays and legal holidays, if immediate compliance is no[poss�ble. If he canno�comply with the request <br /> within thac time,he shall so inform[he individual,and may have an addidonal five days wi[hin which to comply wirh the request, excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.�l. Procedure when data is not accurate or complete. An individual may con[est the accuracy or completeness of public or private <br /> data conceming himseif. To exercise this rieht,an individual shall notify in wnring the responsible au[horiry describing the nature of the disagreement. <br /> The responsible au�horiry shall within 30 days eicher: (a)correct the data found to be inaccurate or incomplete and attempt to notify past zecipien[s of <br /> inaccurate or incomplete data, includine recipienu named by the individual; or(b) nocify the individual tnat he believes [he data to be correct. Data <br /> in dispute shall be disclosed only if the individual's sta[emen[of disagreement is included with the disclosed data. <br /> The decermination of the responsibfe authonry may be aopealed pursuanc to che provisions oP the administranve procedure act rela[ing to <br /> contested cases. <br /> DAT.� PRIV aCY :�DVISORY <br /> In accordance with M.S. 13.04, Subd. �, "Rights of subjects of data", we would like to inrorm 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 /> ":ou are :o�ified thar. <br /> 1, The information you furnish�•��ill be used to detemune your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusai may require that the City deny the permit or Iicense. <br /> 3. The information may be shared wich o[ner local, state or federal aQencies 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 /> j. You have cenain riQhts under �1.5. 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�l S t� �� <br /> 1 rti� � � <br /> First lliddle Lasc <br /> � V �1 <br /> A es �� � � � � <br /> n �,� .✓� <br /> }yL q <br /> City Stace Zip Phone <br /> I understand my rights as stated above. <br /> � �-,�— <br /> Signamre <br />