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Sec.13.04 RIGHTS OF St1BJECTS 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 secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or co�dendal data concerning himself shall <br /> be infocmed of: (a)the purpose and incended use of the requested data within the collecting'state agency, polidcal subdivision,or statewide system; <br /> (b)whe[her he may refuse or is legally required ro supply the requested data;(c)any l�own consequence arising from his supplying or refusing to supply <br /> private or confidendal data;and(d)the idendry of other persons or endties authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesaeative data, pursuant to secrion 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of revenue mav place the noace required under chis subdivision in the individual income tax or properrv tax refund <br /> instrucdons instead of on those forms. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored dxta on individuals, and whether it is classified as public, private or co�denaal. Upon his further request, an individual who is the subject <br /> of stored private or public data on individuals shall be shown the data without any charge[o him and, if he desires, shall be informed of the content <br /> and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafrer unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shalt provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the actual costs of making, cerafying, and compiling the copies. <br /> The responsibie authoriry shall comply immediately, if possibie, 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[ime,he shal(so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Sarurdays, <br /> Sundays and leeal holidays. <br /> Subd.4. Procedure when data is not accu:ate or complete. An individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exercise this right,an individual shafl notify in wricing the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correcc the data found to be inaccurate or incomplete and attempt to notify past recipienrs of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b) notify the individual that he bztieves the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The detzrminadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to <br /> contesced cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we wouid 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 cercain 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 requested. <br /> 2. You may refuse to supply data, but refusal may require that the Ciry deny the pernut or license. <br /> 3. The information may be shazed with other local, state or federal agencies to the extent necessary to process <br /> the pernut 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 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 /> ,i,�;�; ,—.c�u�c.- �T�,� _ <br /> First �Siddle Lasc <br /> Z�f'?9 rNC•tlw.e.ve[7 iV/t.liS �d0 <br /> Address <br /> 7-�tit ,.�t,v S�'ki5 9SG-/d?'� _ <br /> Cih, State Z�p Phone <br /> I understand my rights as stated above. <br /> ���—� `—� a'� <br /> Signature <br />