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♦ ,i <br /> Sec.13.04 RIGHTS OF SiJBJECTS OF DATA . <br /> Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. An individual azked to supply private or co�dencial data concerning himself <br /> shall be informed of: (a)the putpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide <br /> rystem;(b)whether he may refuse or is legally required to suppty the requested data;(c)any Imown consequence arising from his supplying or <br /> refusing to supply private or confidential dara;and(d)the idenary of other persons or entides authorized by sate or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply investigative data, pursuant to seccion 13.82, subdivision 5, to a law <br /> enforcement officer. <br /> 'I�e commissioner of revenue mav lace the notice re uired under this subdivision in the individual income taz or ro ertv tax refund <br /> instrucrions instead of on[hose forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the <br /> subject of stored data on individuals,and whether it is classified as public,private or confidenrial. Upon his further request,an individual who <br /> is the subject 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 <br /> of rhe content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be <br /> disclosed to him for six months thereafter uriless a dispute or action pursuant to this secoon is pending or additional data on the individual has been <br /> collected or created. The responsible authoriry shall provide copies of the private or pub(ic data upon request by the individua]subject of the data. <br /> The responsible authoriry may require the requesang person to pay the actual cosu of making,certifyin„and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or withia five days <br /> of the dace of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compiy with <br /> the request wi[hin that time, he shall so inform the individual, and may have an addidonal five days within which to comp(y wich the request, <br /> excluding Saturdays,Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of pubtic or <br /> private dara conceming himself. To exerzise this right,an individual shall notify in writing the responsibie authoriry describing the nature of the <br /> disagreement. The responsibie authoriry shall within 30 days either: (a)correct the data found to be inaccuiate or incomplete and attempt to notify <br /> past recipienrs of inaccurate or incomplete data,including recipients named by the individual;or(b)noafy the individual that he believes the data <br /> to be correct. Data in dispute shali be disclosed o�ly if the individual's statement of disagreement is included with the disclosed data. <br /> The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relaang <br /> to contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with N1.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your <br /> request for a permit or license from the �ity of Orono or any of its departments may require you to furnish certain <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 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 pernut or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain rights under I�I.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 /> ��,� � ��' ,�,���'�`�L.:ht�—.� <br /> � r, (` � � Midd Last <br /> 7 � �-�N''�ZX� s" ,,�'� �r.� <br /> Address <br /> �:� c� �: :���- ���"l / 5��.�?/� ;r� <br /> > �` / <br /> C�ry State Zip Phone <br /> I understand my rights as stated above. <br /> Signa r " <br /> 6 <br />