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Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Infomiation required to be given individual.An individual asked to supply pnvate or confidential data concerning himself shall be <br /> informed of: (a)the puipose and intended use of the requested data within die collecting state agency,political subdivision,or statewide system;(b) <br /> 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 data:and(d)the identity of other persons or entities authorized by sta�e or federal law to receive the data.This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.32,subdivision 5,to a law enforcernent officer. <br /> The commissioner of revenue mav alace the notice required under this subdivision in the individual income tax or provert�tax refund <br /> instiuctions instead of on those fomis. <br /> Subd.3. Access to data by individual. L'pon request[o a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or confidential. Upon his fiirther request,an individual wllo is the subject 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 infom�ed of the 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 to him for six <br /> monHts thereafrer unless a dispute or action pursuant to this section is pending or additional dsta on the individual has been collected or eceated. The <br /> responsible authoriry shlll provide copies of the private or public data upon request by[he individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual costs of m�king,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,orwithin five days of <br /> the dare of the request,ezcluding Sahirdays,Sundays xnd legal holiduys,if inunediate compliance is not possible. If he cannot comply with die request <br /> within[hat[ime,he shall so infoim dle individual,and may have an additional five duys within which co comply with the request,zxcluding Sactirdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accw'acy or completeness of public or private data <br /> concerning himself. To exercise diis right,xn individual shall notify in writing the responsible authoiity describing the nature of the disagrzement.The <br /> responsible authority sh:ill within 30 days ei[her: (�)conect Ihe data fowid ro be inaccur�te or incomplete and attempt to notify past recipients of <br /> inaccw-ate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be coiTect. Data in <br /> disnute shall be disclosed only if the individual's scatement of disagreement is induded with die disclosed data. <br /> The deterniination of the responsible authority may be appealed pursuant to the provisions of[he administrative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance�vith M.S. 13.04,Subd�,"Rights of subjects of data",we would like to inform you that your request <br /> for a pein�it or(icense from the City of Orono or a�ry 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 detemline your qualification for the perniit or license <br /> requested. <br /> ?. You may refuse to supply data,but refusal may require that the City deny the perniit or license. <br /> 3. The inforniation may be shared with other local, state or federal agencies to the extent necessary to <br /> process the pennit or license. <br /> 4. If your requested pern�it or license requires Coui�cil 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 pernlit. <br /> �(���1�iV�P <br /> First M1liddle Last <br /> � ��o �a "d �4�� �l���k� <br /> Address <br /> ���1�i��S�Q�� �/l Al ����?,� <br /> C�t�' State 7.ip �Phone � <br /> � �!n�erstand n�y riehts as stated abovc. <br /> � � <br /> Si� ture <br /> .i? <br />