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. <br /> _ ♦ <br /> Sec.13.04 RIGHTS OF S[JBdECTS OF DATA <br /> Subd. 1. Type of data. 'Ihe rights of individual on whom the data is stored or to be sto�ed shall be as set focth in this secdon. <br /> Subd.2. Infocmation reqtrired to be pven individual. An individual asked to supply private or confidential data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the iequested data within the collecting 3tate agency,polidcal subdivision,or statewide rysum; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidenaal data;and(d)the idenary of other persoas or enrides authorized by state or federal law to receive the data. This requ"uement shall <br /> not apply when an individual is asked to suppiy invesrigaave data,punuanc to secdan 13.82,subdivision 5, to a law enfarcemenc o�cer. <br /> The commissioner of revenue mav place the nodce rewircd under this subdivision in the individuat income tax or prooertv tax refund <br /> instrucdons instead of on those forms. <br /> Subd.3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subjecc <br /> of stored data on individuals,and whether it is ctassified as public,private or confidential. 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 to him and,-if he desires,shall be informed of the content <br /> and meaning of[hat dara. Afcer an individua!has been shown che private data and informed of its meaning,the data need not be disclosed to him for <br /> siz months thereafter unless a dispuu or acdon pursuanc to this secrion is pending or addidonal data on the individual 6as been cotlec[ed or created. <br /> The responsib(e authoriry 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 requesring person to pay the actual cosu of making,certifying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,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 compiiance is not possible. ff he cannot comply with the request <br /> within rhat time,he sha11 so inform the individual,and may have an addirioaal 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 completeness of public or private <br /> dara conceming himself. To exereise ehis righG an individual shall noafy in wricing the respoasible authoriry describing che nature of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct[he data found to be inaccurnte or incomplete and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, including recipients named by che individual„or(b)nodfy the individual that he believes the data to be coaect. Data <br /> in dispute shati be disclosed only if the individual's stacement of disagreement is included with the disclosed data. <br /> The determinadon of the rosponsible auchoriry may be appealed pursuant to the provisions of the administradve procedure act relating to <br /> contesud cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you thai 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 determine your qualification for the permit or iicense 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 extent 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 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 o permit. <br /> �!�Q�1 � /-� OZcD�t M�.e(G(G� <br /> First Middle Last <br /> Address �� /�/'(�- ��� .�� �-� . <br /> � --Q/�'� � `1 i <br /> Ciry State Zip Phone <br /> I understand ri e• <br /> � ' <br /> Signaare <br /> _ ..___.-�--- <br />