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. ' -� . <br /> Scc.13.0d RIGII'1'S OF SI'BJECTS OF DATA <br /> Subd I. "�ype of data. The nghts of individual on whom the data is stored or ro be stored shall be as set forth in diis section. <br /> Subd.2 Inibnnation required to be given individual.An individual asked to supply private orconfidential data concerning himselfshall be <br /> infonned of� (a)the purpose and intended use of the requested data widiin the collecting state agency,political subdivision,or state�vide sqstem:(b) <br /> whether he may refuse or is Iegally required to supply the requested data;(c)any kno���n consequence arising from his supplying or refusing tu supply <br /> private or confidential data;and(d)the identity ofother persons or entities authorized by state or federnl law to receive the d�tta. This requirement shall <br /> not apply when an individual is asked to suppl��investigative data,pursuant to scction 13.82,subdivision 5,to a la�v enibrcemen[o�ticer. <br /> The commissioner of revenue mav place the notice required under this subdivision in dic individual income tas or propertv tax refLnd <br /> instructions instead ofon thosc forn�s. <br /> Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed�vhether he is dir suhject of <br /> stored data on individuals,and whether it is classified as public.private or contldential. Upon his iLrther requcst,an individunl who is the subject ol <br /> stored private or public data on individuals shall be shown the data without any charge ro him and,ifhe desires,shall he informed of tl�c content and <br /> meaning of�that data- A�ter an ii�dividual has been sho�vn the private data and infonned of its meaning,the data need not be disclosed to him for si� <br /> months ther�after unless a dispute or action pursuan[to this section is pending or addiuonal data on the individual has been collectcd or crcated Thc <br /> responsible�uthoriry shall provide copies of thc private or public data upon request b��the individual subject of thc data. 'Che responsible authorit}� <br /> may require the requesting person ro pa��the actual costs of making,ccrtih�ing,and compiling die copies. <br /> I�he responsible authorit��shall compl��immediately�,it possible,with any request made pursuant to this subdivision,or���ithin fi��e da�s of <br /> the date of the reyuesi,excl�iding S�turuays.Sunda,:s anti iegal holidays,ii immediate compliance is not possible. If�he�annut compl����nh the request <br /> �cithin d�at time,he shall so inform the individunl,and may have an additional tive days within���hich to comply with the request,e�cluding Saturda��s, <br /> Sund2ys and legal holidays. <br /> Subd.4. Procedure when data is notaccurate or complete. An individual may contest the aceuracy or completeness of public or private data <br /> conceming himsclf. 'I�o esercise this right,an individual shall notify in�vriting the responsible authority describing the nauire ofthe disagreement- The <br /> responsible authority shpll within 30 days either (a)correct the data found to be inaccurate or incomplete and attempt to noti�y past recipients ol <br /> ii�accurate or ineomplete data,including recipients named b��the individual;or(b)notity the individuai that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if lhe individual's statemcnt of disagreement is included with the disclosed data. <br /> "I�he detennination of the responsible authority may be appealcd pursuant to the provisions of the administrative procedure act rclntine to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance���ith M.S. 13.04.Subd.?."Rights of subjects of data",we would like to inti>rm you that��our requcst <br /> for a permit or liccnse from the City of Orono or anp� of its dcpartments may require you lo furnish ccrtain private or <br /> confidential int��rmation. <br /> You are notitied that: <br /> I. The information you t�urnish will be used to determine your qualitication 1or the permit or license <br /> rcqucstcd. <br /> 2. You may refuse to supply data,but refusal may require that the Cit�°deny the permit or licensc. <br /> 3. The information may be shared with other local. statc or federal aeencies to the extent necessaiy to <br /> process the permit or license. <br /> 4. If your requested permit or license requires Council actioi� to approve, some informatioi� may become <br /> public. <br /> �. You have certain rights under M.S. 13.0�(available upon request)lo revic�v private data un yourscif�. <br /> 6. Your full name is required to process this application or permit. <br /> �'�"� �J L�.v� �IAC�.,1/�,l C V�.� <br /> First 11iddlc Last <br /> J U �� S 1 �,�cQ(� ���� � I�c� <br /> Ad d ress <br /> ���:,,�� ��,� ss 3 v 3 ysa;s�7 -/eoo <br /> City Statc Zip Phone <br /> 1 understand my rights as stated above. <br /> �z..�.-�, ,> ` . <br /> Signahire � <br /> Reset Form - 32 <br />