2001-P03834 - pool - Laserfiche WebLink

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� I �, , Sec.13.04 RIGHTS OF SLTBJECTS OF DATA Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given indiridual. An individual�sked to supply private or confidential data conceming tumself shall be informed of: (a)the purpose and intended use of the requested data wi[hin the collecdng state agency,poliacal subdivision,or stacewide rystem;(b)whe�her he may refuse or is legally required to supply the requested data; (c)any Imown consequence arising from his supplying or refusing to supply private or confidendal dara;and(d)the idendry of other persons or entides au[horized by snte or federal law to receive the data. This requiremenc shall not apply when an individual is asked to supply investigative data, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer. 'I�e commissioner of revenue mav olace the notice reouired under this subdivision in the individual income raz or orocerrv tax refund instrucrions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidenrial. Upon his further request,an individual who is the subject of stored private or public data on ir.dividuals shall be shown the data without any char�e to him and, if he desires, shall be informed of the contenc and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disctosed to him for sir months thereafter unless a dispute or acdon pursuant to this sec6on is pending or addidonal data on the individuai has been collected or created. The responsible authoriry shall provide copies of the private or pubtic data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual cosu of making,certifyin„and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision, or wichin five days of the date of the request,excluding Saeurdays,Sundays and legal ho(idays, if immediate compliance is noc possible. If he cannot comply with the request within that time, he shall so inform[he individual, and may have an addirionai five days within which to comply wi[h[he request, excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private da[a conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authority describing the nature of[he disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiere and attempt to nodfy past recipiene�of inaccurate or incomplece dara,including recipients named by the individual;or(b)nodfy the individual that he believes the dsn [o be correct. Data in dispute shall be disclosed only if the individual's statemen[of disagreement is included with the disclosed data. The determinaaon of the resporuible authoriry may be appealed pursuant to the provisions of the adminisQadve procedure act celaring to contested cases. DATA PRIVACY ADVISORY In accordance with N1.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your request for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified [hat: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared wi[h other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested pernut or licease requires Council action to approve, some information may become public. �. You have certain rights under Iv1.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. �G.��` �, t-�?�'.7��.5�f/ First Middle Last 6' �l� vv�y�� /�. Address S 1`- �-C"��'-�.��" �''i'`�� /�i� ��S�Z-� C��Y State Zip Phone I understand my rights as stated above. ,__� �- Signature 6