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„ . . <br /> Sec.13.04 RIGHTS OF SUBJECTS OF UATA <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. [nformation required to be given individual. An individual asked to supply private or confidential data conceming himself shal I be <br /> informed of: (a)the purpose and intended use of the requested data within the 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 state or federal law to receive the data. This requirement shal I <br /> not apply when an individual is asked to supply imestigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individuaL Upon request to 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 further request;an individual who 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 informed of the content and <br /> meaning of[hat 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 /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authority <br /> may require the requesting person to pay the actual costs of making,certifying and eompiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannotcomply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data <br /> conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement. The <br /> responsible authority shall within 30 days either (a)correct the data found to be inaccurate or incomplete and attempt to notify pas[recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant[o the provisions ofthe administrative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data”,we would like to inform 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 /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to <br /> process the permit or license. <br /> 4. If your requested permit or license requires Council 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 permit. <br /> � <br /> First Middle La � <br /> �O �I � 5 /�.� /�v � �G� ,�j �� <br /> Address <br /> City State 'Lip Phone <br /> I understand y ri ts as stated abo e. <br /> � <br /> Signature <br /> g Reset Porm 32 <br />