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l � <br /> . Sec.13.04 RIGHTS OF SLJB.fECTS OF D?�Ta ' <br /> Subd. i. Type of data. 'Ihe righcs of individual on whom�he data is sroced or ro be scorcd shall be as set forch in ctus secrion. <br /> Subd.2. Information reqirired to be given indiridual. An individual asked to supply priva[e or confidenrial dara concerning himself shall <br /> be informed of: (a)che purpose and incended use of the requused dam wichia the collecang Yute agency,poliacal subdivision,or statewide rysum; <br /> (b)whecf:er he may refuse or is.legally requir.d to supply che requesced data;(c)any lmown coasequcnce arising from his supptyiag or refusing m supp[y <br /> privace or confider.dal data;and(d)che idenary af ocher per�oas or enodes authocized by state or federel law to receive the dara. This requiremenc shall <br /> not apply when an individual is asked to supply invesd¢adve daa,pursuant to secdon 13.82, subdivision 5, to a law enfoczement o�cer. <br /> The ce^imissioner of revenu- mav pla-- �he nodc- rauired und-r this subdivision in the individual income tax or orooem taz refund <br /> instrucdons inscead of on[hose forms <br /> Subd. 3. access to data by individ�:al. Upon request to a responsible authoriry,an individual shall be informed whe�her he is che subjecc <br /> of stoced da�t on individuals,and whechu it is classified as public,private or confidenaal. Upon his further request,an individual who is the subjecc <br /> of stored private or public daa on individuals shall be shown che dam wi�houc any charge to him and,�if he desires, shall be informed of the eontanc <br /> and meaning of[ha[data. After an individual has be�n shown[he privare dan and informed of iu meaaing,the daca need not be d'uclosed to him for <br /> six manchs thereafter unless a dispute or acdon pursuan�to this secdon is pending ar addidonal dara on the individual hu been coilecmd or creaced. <br /> "Ihe responsible authociry shall providz copies of the privare or public data upon request by the individual subjcct of[he da�a. The responsible authoriry <br /> may tequir:che requesdng person to pay the accual costs oi makin2, cerafying,and compiling the copics. <br /> 'ihe responsible au�horiry shall comply immcdiately, if possible, wich aay request made pursuant to this subdivision,or within five days of <br /> the dace of the reques�,ezcluding Sacurdays.Sundays and Icgal holidays,if immediate compliance is not possib(e. If he cannot comply with the request <br /> wi[hin[hat dme,he shall so inform[he individual,and may have an addidoaal five days within which co compiy wich the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Ptocedure when data is not accurate or complete. rLz individual may contest the accuracy or completeness of public or private <br /> dara conceming himself. To exercise chis righc,an individual shall noafy in wridng�he responsible auchoriry describing the nature of the disagreemenc. <br /> The responsible authoriry shall wichin 30 days citt:er: (a)correcc tha daca found co be inaccurace or incomple�e and attempc to nodfy past t�cipiencs of <br /> inaccurace or incomplece data, including recipiencs named by the individual; or(b)nodfy the individua!thac he believes the data to be correcG Data <br /> in dispuce shall be disclosed only if[he individual's stacemenc of disagreement is included with che disclosed data. <br /> The decerminadon of the rosponsible authoriry may be appealed pursuanc to the provisions of tha admirustrarive procedure act reladng to <br /> concested cases. � <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri;hcs of subjects of data", we would like to inform you that your request <br /> for a pernut or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidencial information. <br /> You are notified that: <br /> 1. The information you furnish will be used to decermine your qualification for[he permit 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 wich ocher local, stace or federal a;encies to the ettent 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 M.S. 13.04 (availabte upoa request) to review private data on yourself. <br /> 6. Your full name is required to process this application or permi�. <br /> i ,� <br /> 1 11t�i.�.. ��s J�� y �'u r� e ✓� - . <br /> First �fiddle Last <br /> Address <br /> Ciry State Zip Ptione <br /> I understand my rights �s stated above. <br /> ' =�__ <br /> Signature <br />