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.. _ _ ' f <br /> Sec.13.04 RIGHTS OF SUB.TECTS OF D,�TA • <br /> Subd. 1. Type of data. The righcs of individual on whom the data is s[ored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information reqtirired to be given individual. An individual asked to suppiy private or confidendal data concerning himself shail <br /> be informed of: (a)the purpose and intended use of the reques[ed data wichin rhe collecang'state agency, polidcal subdivision,or statewide system; <br /> (b)whether he may refuse oY is legaily required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply <br /> private or confidendal data;and(d)the idenriry of other persoas or endaes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrigarive data,pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of re�•enue mav place the noace reauir�d under this subdivision in the individual income tax or propertv tax refund <br /> instructions insczad of on those forms. <br /> Subd. 3. Access to data by indiridual. Upon request to a responsible auchority,an individual shall be informed whether he is the subject <br /> of stored data on individuals, and wherher it is classified as public, priva[e or confidenaal. Upon his funher request, an individual who is the subject <br /> of 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 <br /> and meaning of that data. Afrzr an individual has been shown the private data and informed of irs meaning, the data need not be disclosed to him for <br /> six monchs thereafter unless a dispute or acrion pursuanc to [his secaon is pending or addidonal data on the individuai 6as been collected or created. <br /> The responsible authoriry shali provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesring person to pay[he actual costs of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediatety, if possible, with any request made pursuant to this subdivision, or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addirional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal hofidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of pubiic or private <br /> data concerning himself. To exercise[his rieht,an individual shall nodfy in wriang the responsible authoriry describing�he narure of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccumte or incomplete data, inciuding recipients named by [he individual;,or(b)nodfy the individual thac he believes the data to be correct. Data <br /> in dispuce shall be disclosed oniy if the individual's statement of disagreement is included with the disclosed data. <br /> The de[erminarion of the respensible au[horiry may be appealed pursuant to the provisions of the administrarive procedure act reladng to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Ri�hts 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 /> confideatial information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the pemut or license 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 o[her local, state or federal a?encies to the extent necessary to process <br /> 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 ri�hts under N1.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 /> �� U �-.�- .3'�-'-. <br /> First n I � iddle Last <br /> ���� J��S� lv��r� � �� — <br /> Addr � / _ �� �� <br /> l r VJ �� Y � <br /> City Stace Zip Phone <br /> i � <br /> j <br /> I understand my ��- �st ed above. <br /> G <br /> Signature <br />