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i <br /> Sec.13.04 RIGHTS OF SUB.JECTS OF D?�T?� <br /> Subd. 1. Type of data. The righrs of individual on whom[he data is stored or to be stored shall be as set forth in this secdon. <br /> Subd.2. Information required to be given individual. An individual asked to supply priva[e or confidenrial data conceming himself shall <br /> be informed of: (a) the purpose and intended use of the requested data wi[hin the collecting'state agency, political subdivisiou,or statewide system; <br />(b)whecl:er he may refuse oY is legalty required[o supply the requested data;(c)any k�own consequence arising fmm his supplying or refusing to supply <br /> private or conr"�dencial data;and(d)the identity of other persons or enrides authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesdeadve dara, pursuanc to section 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re enue mav place [he norice reauired under this subdivision in the individual income tax or propertv tax refund <br /> instruc[ions instzad of on those forms. <br /> Subd. 3. Access to data by indi��dual. Upon request to a responsible authority,an individual shall be informed whether he is the subject <br /> of stored data on individuals, and whether it is classified as public, private or confidendal. 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 that data. Aftzr an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to hicn for <br /> six mon[hs[hereafter unless a dispute or acrion pursuant to this section is oending or addiaonal data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the priva[e or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the requesting person to pay the acrual cos[s of making, certifying, and compiling ihe 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,exc(uding Sacurdays,Sundays and legal holidays, if immediate compliance is no[possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which to comply wi[h the request,excluding Sarurdays, <br /> Sundays and legal hotidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private <br /> data cor.cerning himself. To exercise[his rieht,an individual shall nodfy in writing the responsible authori[y dzscribing[he nature of the disagreeme�t. <br /> The res�onsible authoriry shall within 30 days either. (a)correct the data found to be inaccu[ate or incomplete and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data <br /> in dispuce shail be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> Tfie de�erminarion of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng to <br /> contested 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 determine your qualification for the permit or license requested. <br /> ? 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 a�encies to the extent necessary to process <br /> the permit or license. <br /> .�. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> �. 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 /> � � -;i-ti� ti. ti. <br /> �'06 !,.� ,�_�_�. � <br /> First �fiddle Last <br /> , �{- 7�- , i � %�4,�'� � 'r ' ; <br /> �} � �-> _ .� � � <br /> .�d res��l/�,•Z [ /7�� I''I �- � � -?���. � '�� _� l:� <br /> Ci[v State Zip Phone <br /> I understand my rig�as stated �ve;,y <br /> i;� / . ` <br /> �I �L <br /> � <br /> Si¢na[ure � � <br />