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y , � <br /> Sec.13.0� RtGHTS OF SUBJECTS OF D�T.�► <br /> Subd. 1. Type of data. 'Ihe righcs oi individual on whom che data is scored ar to be stored shall be as sec forth in rhis sccdon. <br /> Subd.=. Information reqtrired to be given individual. �a individual asked to supply private or contidendal dact concerning himself shall <br /> bz informed of: (al che purpose and in�ended use of che requested dara wichin che coqeccing'state agency, polidcal subdivision,or stacewide rysum; <br /> (b)whecher he may retuse or is legally required to suoply the requesud data:(c)any lrnown consequence arising from his supplying or refusing to supply <br /> private or confidendal data:and(d)�he idenacy of o�her persoas or endtics authorized by srace or federal taw co receive�he daea. This requiremenc shall <br /> noc appiy when an individual is asked to supply invesdgarive data, pursuaac to secdon 13.82, subdivision�, co a law enforcement o�cer. <br /> The commissioner of revenue mav olac the noac reauired under this subdivision in the individual income raz or ocopem raz refund <br /> ins[rucaons inscead of on thase focros. <br /> Subd. 3. :�ccess to data by iadividual. Lpon request to a cesponsible auchoriry,an individual shall be iaformed whether he is the subject <br /> oi stored dara on individuals,and whecher it is ctassitied�s public,private or conridznaal. L'pon his furrher requesc,an individual who is che subjecc <br /> of scored private or pubtic daea on individuals shal!be shown ehe data wi�houc any charge to him and, if he desires, shall be informed of che concent <br /> and meaning of chat data. :�fter an individual has been shown che privace daea and informed of ia meaning,the data need noc be disclosed to him for <br /> six mon�hs ehereaiter unless a dispute or acdon pursuanc co chis secrion is pending or addidooal data on�he individual has been collected or creaced. <br /> The responsibte au�horiry shall provide copies of che privare or public da�a upon requesc by�he individual subject o[che data. The responsible aurhoriry <br /> may require [he requesting person to pay the acaal cosu of making.cerafyin¢,and compiling che copies. <br /> The responsible au[horiry shail compiy immediace(y, if possible, wich any request made pursuanc to[his subdivision,or wi[hin five days of <br /> the date of the request,txcluding Saturdays.Sundays and le¢al holidays.if immedia[e compliance is not possible. If he canno[comply with the requesc <br /> wichin�hac dme,he shali so iniorm che individual,and may have an addidonai five days wichia wlvch to comply wi�h the requesc,excluding Sacurdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is aot accunte or complete. An individual may contest the accuracy or completeness of public or private <br /> data concerning himself. To exe►cise[his nght,an individual shall nod'ry in wntin8 the responsible aurhoriry describing[he nacure of the disagreement. <br /> The responsible auchoriry shall within 30 days eicher: !a)correcc the dara found to be inaccurace or incompiete and accempt to nodfy past recipients of <br /> inaccurace or incomplece data, includin¢ recipiencs named by che individual: or(b)nod"ry the individual chac he believes the data to be correcc. Data <br /> in dispute shall be disclosed only if the individua!'s scaremen[of disaereement is inctuded wict►the disclosed dara. <br /> The determinadon of the responsible auchoricy may be appealed pursuant to the provisions of the adminiscraave procedure act relacing [o <br /> concested cases. <br /> DAT� PRIVACY ADVISORY <br /> In accordance wi[h M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your request <br /> for a permic or license from the Cicy of Orono or any of its deparcmen[s may require you to furn.ish certain pri�•ate or <br /> confidencial informacion. <br /> 'lou are ao[ified that: <br /> 1. The information you furnish will be used to decermine your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the Ci[y deny the permit or license. <br /> 3. The information may be shared wich o[her local, sta[e 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 /> �, 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 /> � IDC..,K C �Cc�LG � Uf�T � �n a <br /> First <br /> ldiddle �� <br /> Z3��� > �e l < <�, ., �� - <br /> Address /� Z2�'7�'�� <br /> j'�� �S � �/V �s y�y � <br /> Ciry Sm� ZIP Phone <br /> I undentand my rights as stated above. , <br /> �� v � <br /> �- <br /> Signature <br />