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� <br /> Sec.13.04 RIGHTS OF SUB�TECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the daa is stored or to be srored shall be as set farth in this secdon. <br /> shall be info ed of:��d��on���to be given mdividual, pn i�iv-�:�1�sked ro supply private or confidendal data concerning himself <br /> () purpose and incended use of the requesud data a,-�in the collecting state agency,political subdivuion,or stacewide <br /> system;(b)whether he may refuse or is IegaUy required ro supply the reques�i data,(c)any�own coasequence arising from his supplying or <br /> refusing m supp(y private or confidential data;and(d)t�e idenary of odxc petsoas or enaaes authorized by snte or federal law co receive the data. <br /> This requirement shall not apply when an individual is asked to suppiy im-,.srigaave data, punvant ro secdon 13.82, subdivision 5, to a law <br /> enforeement officer. <br /> The commissioner of revertue mav�lace the norice rcwired under�s subdivision in the individual income tax or orocenv rax re{und <br /> in�t�ctions tnstead of on those fortns. <br /> Subd.3. Access to data by iadividual, Upon request ro a respoasble authoriry,an individual s6a11 be informed whether he is the <br /> subject of stored data on individuals,and whether it is class�ed as public,private or confidenaal. Upon his further request,an individual who <br /> is the subject of stored privare or public data on individuals shall be shown the«�without any charge m him and,if he desires,shall be informed <br /> of the content and meanin�of that dara. Afcar an individual has been shown t�e private data and informed of its meaaing,the data need not be <br /> disetosed to him for six monthc thereafter unless a disFuu or action pucwane eo this secdon is pending or addiaonal data on the individual has been <br /> coqected or created. The responsble authoriry shall provide copies of dx privax or public data upon request by the individual subject of the data. <br /> The responsible authoriry may require the requesdng pecson to pay the actual costs of making,cerdfying,and compiling the copies. <br /> The responsible authoriry shall comply immediately,if possible,wi�aay request made pursuant w this subdivision,or within five days <br /> of the dau of the request,ezcluding Saturdays,Sundays and legal holidays,��cnediate compliance is not possible. If he cannot comply widi <br /> [he request within that time,he shall so inform the individual,and may have an addidonal five days within which ro comply with the request, <br /> excluding Saturdays,Sundays and legal holidays. <br /> Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuncy or completeness of public or <br /> private data conceming himself, To ezercise this right,an individual shail nodfy in writing the responsible authoriry descdbing the tiaaue of the <br /> disagreement The respons�ble authoriry sha11 within 30 days either: (a)correa d�e data pound ro ya inaccurdre or iixomplete and aaempt ro nodfy <br /> past recipienrs of inaccuraoe or incomplerc data,incluAin�mcipients named by rhe individual;or(b)notify the individual that 6e believes the data <br /> ro be correct.�Data in d'upu[e shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The dererminaaon of the responsible authoriry may be appeaizd purs�ant to the provisions of the adminisorative procedure act relating <br /> to contesud cases. <br /> UaTA PRIVACY�iDVI ORY <br /> In accordance with M.S. 13.04, Subd. 2, "Righcs of subjecu of data", we would like to inform you that your <br /> request for a permit or license from the �ity of Orono or any of its departments may require you to furnish certain <br /> private or 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 <br /> 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 euent necessary to <br /> process the permit or license. <br /> 4. If your requested permit or license requires Co�action to approve, some information may become <br /> public. <br /> 5. You have certai,n rights under 41.S. 13.04(available upon request) to review private data on yourself. <br /> 6. Your full name is required to process this applicarion or permit. <br /> � � ���� �� Sfi, <br /> First � �tiddle <br /> I.ast <br /> 11 � u p "� �—t-� ^�P 1 P � <br /> Address <br /> � ��n r-�D a�C.k �'l*� �i�'�3 Q 57 �7 22 t tt'Z <br /> C�ry Sate Zip Phone <br /> I understand " ts as stated above. <br /> Signamre <br /> 6 <br />