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, , <br /> Sec.13.04 RIGHTS OF SLTB,TECTS 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 s_=;.a. <br /> Subd.2. Information required to be given individual. An individual�sked ro supply private or confiden�al dara concer�.�-:imself <br /> shall be informed of: (a)the purpose and intended use of the requested data within[he collecdng state agency,political subdivision,c-::-�,widz <br /> systeri�;(b)wht4f�e�he may refuse or is legally required to supply the requested data; (c)any lrnown cocuequence arising from his s�-:,ing or <br /> refu3ing co svpply private or confidendal dara;and(d)[he idenrity of o[her persons or entides authorized by smte or federal law ro recei•:o=a data. <br /> '•, 'I'his requirement shall not apply when an individual is asked to supply invesri;ative data, pursuant to secrion 13.82, subdivision:. = a law <br /> enforcement officer. <br /> The commissioner of revenue mav lace the norice re uired under this subdivision in the individual income taz or ro em _-refund <br /> instrucrions instead of on those forms. <br /> Subd. 3. Access to data by indiridual. Upon request to a responsible authoriry,an individual shall be informed whe�:e-=e is the <br /> subject of stored data on individuals,and whether it is classified as public,private or confidennal. Upon his further request,an ind:��^1 who <br /> is[he subject of stored private or public daa on individuals shall be shown che data without any char;e to him and, if he desires,shall t�=�rmed <br /> of[he conrent and meaning of that data. After an individual has been shown the private data and informed of its meanic�, the data;_--��oc be <br /> disclosed co him for six months thereafter unless a dispute or action pursuant to dus secoon is pending or addirional data on che individ��been <br /> collected or creared. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject c.'�_data. <br /> The responsible au[horiry may require the requesring person to pay the actual costs of making,certifying,and compilir.g the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any requesc made pursuant ro this subdivision,or withir.`-:�days <br /> of the date of the request,excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot cc=_:�, with <br /> the request within that dme, he shall so inform the individual, and may have an additional five days within which to comply with c_ _-��uest, <br /> excluding Saturdays, Sundays and legal holidays. ' <br /> Subd.4. Procedure when data is not accurate or complete. An individuai may concest the accuracy or comple�eness e'�__Iic or <br /> private data concerning himself. To exer�ise this right,an individual sha(1 nodfy in writing the responsible authoriry describing the ra_:of the <br /> disagreement. The responsible authoriry shall within 30 days either. (a)correct the dara found to be inaccurate or incomplz�,and atter.:��odfy <br /> pasc recipiena of inaccurate or incomplete dara,including recipienu named by the individual;or(b)notify the individual tY�ac he belie�_s�:data <br /> to be correct. Data in dispute shall be disclosed only if th�individual's statement of disagreement is included with the disclosed dae. <br /> The dererminarion of the resporuible authoriry may bz appealed pursuan[co the provisions of the adminis�ao�e procedure a�:-:!adng <br /> to contested cases. <br /> D�TA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you t:=:your <br /> request for a permit or license from the City of Orono or any of its departments may require you to furnish �e:tain <br /> private or confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or ���nse <br /> requested. <br /> 2 You may refuse to supply data, but refusal may require that the Ciry deny the permit or lice�_. <br /> 3. The information may be shared with other local, state or federal agencies to the extent nece_:�-y to <br /> process the permit or license. <br /> 4. If your requested pemut or license requires Council action to approve, some information may�=�ome <br /> public. <br /> 5. You have certain rights under N1.S. 13.04 (available upon request) to review private data on}�r�self. <br /> 6. Your full name is required to process this application or permit. <br /> �'7����LJC E h ,L�t�'�c"���� <br /> F�rst Middle Last <br /> 4r�� /�/ieou.�=; AV� . <br /> Address <br /> �� i�v�Jt=� poc.�5 '`�'V S��c�� ��/2- ��l- �� Pc� <br /> C�ry Srate Zip Phone <br /> I understand my rights as stated above. <br /> � - �� c�e-L-� <br /> Signantre / <br /> G f <br /> 6 <br />