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. . <br /> Sec.13.0�1 RIGH'I'S OF SUBJECTS OF DaT� <br /> Subd. 1. T}ge of data. 'Ihe riehcs of u:dividual on whom tha data is stor�or to be scored shall be as set forth in this secdon. <br /> Subd.3. Informadon reqirired to be given individual. An iLdividual asYc3 to supply privace or confideadal data concerning himself shall <br /> be informed of: (a)che purpose and inrended use of che requesccd dam wi�in the colleccing'state agency,policical subdivision,or sntewide system; <br /> (b)whether he may refuse oi is legally required to supply[he requested daa;(c)any Icown coasequence arising fmm his supplying or refusing to supply <br /> privace or conndential data;and(d)the idenriry of oeher perso�s or enriri:s z�chorized by s�ate or federal law to receive the data..This requ'uemeoc shall <br /> no�apply when an individual is asked to supply invesriearive daci,purn:�ac[o secaoa 13.82,subdivision 5, to a law enforcement officer. <br /> The commissioner of re�enue r�av pia�e the nodce reauired ❑rd�r this subdivision in che individual income tax or orooem tax refund <br /> inscructions insczad of on those forms. <br /> / Subd. 3. �ccess to data b�indi�zdual. Upon request to a rospoasible aet^oriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals, and whe[her it is classified as public,priva4 or confid=r.ria1. Upon his further request,an individual who is the subjec[ <br /> of scorzd private or public data on individuals shall be shown che da�a wiu ouc any c':iarge to him and,-if he desires, shall be informed of the contenc <br /> a.^.d meaning of�hat data. Afrer an individual has been shown the priva��ac�and in:ormed of its meaning.che data need not be disclosed to him for <br /> six monchs chereafter unless a dispute or acrion punuan[to chis secaon is c��ding or addirional data on the individual has been collectzd or creaced. <br /> The responsible au�horiry shall provide copies of the privace or public daca a�on reques:by[he individual subject of the dara. The responsible authoriry <br /> r..ay require rhe requesting person to pay the ac�ual costs of making,ce^:;ing, and compiling the copies. <br /> The responsible auchoriry shall comply immediacety, if possib!.,wich an}' rquest made pursuant to this subdivision,or wichin five days of <br /> th�date of che request,ezciuding Sanirdays,Sundays and legal holidays,ii ir^..mediate compliance is not possible. If he cannot comply with the request <br /> wi�4in thac dme,he shall so inform[he individual,and may have an addice;.al five days wirhin which to comply with the request,ezciuding Sacurdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data u not accurate or complete. ?.n individuzl may con[est the accuracy or completeness of public or pri�•ate <br /> da[a concerning himself. To exercise this rieht,an individual shall nodEy ia wridng�:=responsible authoriry dzscribing the nature of the disagreement. <br /> 'I�e responsible auchoriry shall within 30 days either: (a)correce the dan tcund to be inaccurate or incomple�e and attempt to nodfy past recipiencs of <br /> i^accurate or incomplete data, inciuding recipien�s named by thz individL�I;or(b) r_odfy the individual thac he believes the data to be coaect. Data <br /> ia dispuce shall be disctosed only if che individual's statemenc of disagr::�=nt is i^.c:::ded with the disclosed data. <br /> Ttie de�ecminarion of the rzsponsibte au�horiry may b� appea�=� pursuar.:to the provisions of[he admuiistrarive procedure act relaang to <br /> contested cases. <br /> DAT� PRIV�CY AD�ZSORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri;hts of subjects of data", we would like to inform you tha[your reauest <br /> for a pemut or license from the City of Orono or any of ia deparwents may require you to furnish cenain private or <br /> confidential information. <br /> You are notified thar. <br /> 1. The information you furnish will be used to de:ermine�'our qualification for the pemut or license requested. <br /> 2, You may refuse [o supply data, but refusal may require that the City deny the permit or license. <br /> 3, The information may be shared wi�h o�her loc�l, stace or federal agencies to the excent necessary to process <br /> the permit or license. <br /> 4. If your requested permi[ or license requires Council ac[ion to approve, some information may become <br /> . public. <br /> j. You have certain ri�hts under M.S. 13.04 (available upon request) [o review private data on yourself. <br /> 6, Your full name is required to process this application or perm.ic. <br /> Firsc �Siddle Lasc <br /> Address <br /> Ciry State Zip Phone <br /> I understand m nQ ts as s ted above. <br /> � / <br /> Signa[ure <br />