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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 data is stored or to be stored shall be as set forth in this section. ' <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning hunself shall <br /> be informed of: (a)the purpose and intended use of the requested data within the collecdng state agency, political subdivision, or statewide system; (b) <br /> whether he may refuse or 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 identiry of other persons or enddes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesrigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of revenue mav place the noace reauired under this Subdivision in the individual income tax or propertv tax refund instrucdons <br /> instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority, an individual shall be informed whether he is the subject of <br /> stored dah on individuals,and whether it is classified as public,private or confidendal. Upon his further request, an individual who is the subject of stored <br /> private or public data on individuals shall be shown the dara without any charge to him and, if he desires, shall be infortned of the content and meaning <br /> of that data. After an individual has been shown the private data and informed of iu meaning, the data need not be disclosed to him for siz months <br /> thereafter unless a dispute or acUon pursuant to this section is pending or additioual data on the individual has been collected or created. The responsible <br /> authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the <br /> requesring person to pay rhe actual costs of making, certifying, and compiling the copies. <br /> The�esponsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the <br /> date of the request,excluding Satutdays,S�ndays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within <br /> that time,he shall so inform the individual,and may have an additional five days within which to comply with the request, ezcluding Saturdays, Sundays <br /> and legai holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To exercise this right, an individual shall notify in wricing the responsible authoriry describing the nanire of the disagreement. The <br /> responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipienu of inaccurate <br /> or incomplete daa,including recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data in dispute shall <br /> be disclosed only if the individuaPs statement of disagreement is included with the disclosed data. <br /> The determinaaon of rhe responsible authority may be appealed pucsuant w the provisions of the administrative procedure act relating to contested <br /> 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 that your request <br /> for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. T'he information you fumish will be used to determine 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 extent necessary to process <br /> the pernut or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become 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 /> � <br /> ��-A� �/1� ���,�,�cl� �r�= <br /> Firs� � —'Mi dl Last <br /> � � - r� <br /> Address ' y� <br /> f. �� � � �� <br /> City State ip Phone <br /> I understand my rights as stated abo�v -. <br /> � . <br /> Signatu <br /> 10 <br />