2002-P05328 - re-side - Laserfiche WebLink

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l � Sec.13.04 RIGH'TS OF SiJB.TECTS OF D�TA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked ro supply private or confidendal dara concerning himself shall be informed of: (a)the purpose and intPnded use of the requested data within the collecang"state agency,polidcal subdivision,or sratewide system; (b)whe[her he may refuse oY is legally required to supply the requested data;(c)any irnown consequence arising from his supplying or refusing to supply private or confidendal data;and(d)the idenriry of ocher persoas or enrides authorized by state or federal law to receive the data. This requ'uement shall not apply when an individuai is asked to suppiy investigadve dam, punuant to section 13.82,subdivision 5, to a law enforcement o�cer. The commissioner of re�•enue mav place the noace reauired under this subdivision in the individual income tax or oropertv tax refund instructions insczad of on rhose forms. Subd. 3. Access to data by indi�idual. Upon request to a responsible authority,an individual shall be informed whe[her he is the subject of scored data on individuals, and whe[her it is classified as public,priva�e or confidendal. Upon his further request,an individual who is the subjecc of stored privace or public data on individuals shall be shown�he data wi�hout any charge to him and, if he desires, shall be informed of the content and meaning of�hat data. Afrer an individual has been shown�e privace data and informed of its meaning, the data need not be disclosed to him for six months thereafrer uriless a dispute or acrion pursuan�to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authoriry shalt provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesring person to pay the actual coscs of making,certifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of the date of the request,excluding 5aturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request wi[hin[hat time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise this right,an individual shali noafy in wriang the responsible authoriry describing[he nacure of the disagreement. The responsibte authoriry shall within 30 days either. (a)correct[he data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipiencs named by the individuai;,or(b)nodfy the individual thac he be(ieves the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. Tfie determinadon of the respensible authoriry may be appealed pursuant to the provisions of the admuustrative procedure act relaQng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�hts of subjects of data", we would like to inform you that your request for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to deternune your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the pemiit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the pernut or license. 4. If your requested pemut or license requires Council action to approve, some information may become public. 5. You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. �6� 6 (L \ ��'r-!� �-a�� f�C, '�� First � �iiddle Lasc '� `I,� (L�� i��E�;.% I�U�'� _ Address � �(1.��,ti'U �,n� �; �S'�`��v �.�?.-c��z-S S� Ciry State Zip Phone I understand my rights as stated above. � � Signature �