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. �. , <br /> Sec.13.Q4 RIGHTS OF SLTBJECTS OF DAT.�i ' <br /> Subd. 1. Type of data. 'Ihe righcs of iadividual oa whom rhe dan is stoced or oo be swced shall be u sec forch in�his secdon. <br /> Subd.2. Informaaon req�red to be givm indiridual. ?►rs iadividual asked to suppiy privace ar confidecdal data concerniag himtelf shall <br /> be infocmed of: (a)the purpose aad inreaded use of che requured dan wid�ia the collecdag ttate agenry,poGrical subdivision,or sratewide system; <br /> (b)whecher he may refuse oY is.legally requirzd to aupply the requesud data:{e)aay Imown coauquence uising from his supplying or refusing to suppty <br /> privace or confidendal data;and(d)the idenary o[o�hu persaas or earides aurhorized by snte Or fedecai law ro receive che daa. This requiremenc s6a11 <br /> noc apply when an individuat is uked to supQly invadgadve dam,pursuanc ro secaon 13.82,subdivisioa S.w a Iaw entoc�ement officer. <br /> The cec�missioner of rcvenue mav plac- the nodc- r-auired under chis subdivision in che individua! income tax or orooem taz cefund <br /> inscrueaoas inscead of on diose foRns. <br /> Subd.3. Aceess to data by indiv{dual. Upon requesc to a responsible authoriry,an individual shall be informed whaher he is the subject <br /> o[stored daca on individuats,and wheeha ic is elasa�ed as public,private or confidendal. Upon tiis fucther cequest,aa iadividual who is the subjecc <br /> of smred privace or public daa on individuals shall be shown ehe dara wirhouc any charge ro him and;if he desires.shall be informed of ehe contenc <br /> and meaning o[that daa. Af�er an individual has been shown the private dan and informed of ict meaning,the dara need not be d'uclosed oo him for <br /> siz monttu thereaher unleu a dispuu oc acdon pucsuanc w this secdon is pending oc addidonal data on the individual hu been collected or created. <br /> The responsible authoriry shall provide copies of the privam or pubtic dara upon request by the individual subject of rhe data. 'Ihe responsible authoriry <br /> may nquire�e nquesdng person to pay the accual cosu of makiag,eerdfying,and compiling d�e copia. <br /> The responsible aurhoriry shall comply immediacely,if passible,wieh any requesc made pursuanc w chis subdivision,or wichin five days of <br /> the date o[the request,excluding Saturdays,Sundays and legal holidays,if immediace compliance is not possible. If he canaot comply with the requesc <br /> wichin tbat ame,he shall w inform the individual,and may have an addidoeal five days within which to comply wich the request,excluding Saturdays, <br /> Sundays u�d legal holidays. <br /> Subd.4. Procedure whea data is not accurate or eomplcte. An individual may contest the accuracy or eompleteneu of public or private <br /> dara eoncerning himsetf. To exercise this righG an individual shail noafy in wridng ehe respoasible aurhoriry describing the naare of�he disagceemeac <br /> 'Ihe nspoasible auehoriry shal(within 30 days either: (a)correcc rhe data found to be inaccunte or incomple[e and atumpt w nodty past recipienu of <br /> inaccunte or incomplete data,inciuding recipienct named by the individual:oc(b)nodfy the individual that he believes[he dara ro be eocrect Data <br /> ia dispute shall be disclosed only if the individual's statemenc of disagreeme�c is included with the discloud data. <br /> The decermination of the responsible au�horiry may be appealed pucsuanc�the provisions of the adminisaarive procedure aet relating to <br /> contesoed cases. • <br /> DATA PRIVACY ADYISORY <br /> In accordaace with M.S. 13.04,Subd.2, "Righcs of subjects of data",we would like to inform you that your request <br /> for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or <br /> coafidencial 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 /> 2. You may refuse to supply data, buc refusat may require that the Ciry deny the permit or license. <br /> 3. The information may be shazed with ocher local.state or federal agencies to the ettent necessary to process <br /> the permit or license. <br /> 4. If your requested permit or license requires Couacil action to approve, some informatioa 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 permic. <br /> �����-- c - <br /> Finc �tiddle � � Lasc <br /> �Q" �;-. � 55�4�-f I �y ( �-o�v�. <br /> Ciry Sam Zip Phone <br /> I understand my rights as stated above. <br /> (,� ���,cS��f� — <br /> s����« <br />