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� <br /> . � <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The righa of individual on whom the data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information reqirired to be given individual. An individual asked ro supply private or confidendal data concerniag himself shall <br /> be informed of: (a)the purpose and intended use of the requesied data wichia the collecang"state agency,polidcal subdivision,or sratewide system; <br /> (b)whether he may refuse ot is legally required to supply[he mquested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidentiai data;and(d)the idenriry of other persons or enriaes authorized by state or federal law to receive the data. This requirement s6all <br /> not apply when an individual is asked to supply investigauve da[a,pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. <br /> The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or propem ax refund <br /> instrucrions instead of on chose 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 data on individuals,and whe[6er it is classified as public,private or confidendal. Upon his further request,an individual who is ihe subjecc <br /> 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 of the content <br /> and meaning of that data. Aher an individual has been shown[he private dara and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or acdon pursuant to this secdon is pending or addidonal data on the individual has been collected or created. <br /> The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesdng person to pay the actual costs of making, certifying,and compiling the copies. <br /> The responsible authoriry shail comply immediate(y, if possibte,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 requesc <br /> within that time,he shall so inform[he individual,and may have an addiuonal five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete.,An individual may contest the accuracy or compleceness of public or pri�•ate <br /> data conceming himself. To exercise this right,an individual shall nodfy in wricing the responsible authoriry describing the nature of che disagreemenc. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b)nodfy the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only if the individual's statement of disagreement is included with rhe disclosed data. <br /> The determinaaon of the responsible authority may be appealed punuant to the provisions of the adminiscradve procedure act relacing to <br /> contesred cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri;hts of subjects of data", we would 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 certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to detemune your qualification for the 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 with other local, state or federal agencies to the eztent necessary to process <br /> the pemut 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 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 /> �1�_N.n 1..� ��.c�� <br /> pin� Middle Lasc <br /> ��� l�► � a h� ��L7/1 �r — <br /> Address <br /> �5 e'�� ►�-, � � s 3�'� �( Zo- Z�(o�'' <br /> Ciry State Zip Phone <br /> I understand my rights as stated above. <br /> L <br /> Signature <br />