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. y <br /> Sec.13.4i RIGIiTS OF SLTBJECTS OF DAT?► <br /> Subd. 1. Type of data. The righrs of individual on whom[he dara is stored or rn be scored shall be as set forth in this secaon. <br /> Subd.2. Information reqirired to be given individual. �1n individual asked to supply private or confidendal data concerning him5elf shail <br /> be informed of: (a)the purpose and inrended use of the requested data within the collecdng'state agency,political subdivision,or statewide rysum: <br /> (b)wherher he may refuse o'r is legatly cequired to supply the requested data;(c)any known constqueace arising from his supplyiag or refusing to supply <br /> privare or conndenrial data;and(d)the idenary of o�her penoas or enddes au[horized by stare or fedecal law to receive the daca. Ttus requirement s6all <br /> not apply when an individual is asked to supply invesrieadve data, pursuanc to secdon 13.8?,subdivision 5,to a law enforcemenc o�cer. <br /> The commissioner of re�enue mav pla--the nodce rewired under this subdivision in the individual_income tax or proaem taz refur.d <br /> insttucdons inscead of on those forms. <br /> Subd.3. Access to data b�individuaI. Upon requesc to a respansible au[horiry,an individual shall be informed whether he is the subject <br /> of scor�ld data on individuals,and whether ic is ctassified as public,priva[e or confidendal. tipon lus funher request,an individual who is the subjecc <br /> of stored private or public data on individuals shall be shown che dara wichout any charge[n him and;if he desires,shall be informed of che concenc <br /> and meaning of that data. After an individual has been shown the private data and informed of iss meaning,che data aeed not be disclosed to him for <br /> six mon[hs thereafter unless a dispute or acrion pucsuant to this secrion is pending or addidonal dara on the individual has been collected or creared. <br /> The responsible au[horiry shall provida copies of�he private or public data upon request by ehe individual subjecc of the data. The responsible auchoriry <br /> may require che mquesting person to pay the accual coscs of making.cerdfying,and compiling the copies. <br /> The responsible aurhoriry shail comply immedia[ely,if possible,wi[h any request made pursuant to this subdivision,or wi[hin five days of <br /> the da�e of the requesc,excluding Sacuniays,Sundays and legal holidays,if immediace compliance is not possible. If he cannoc comply with die requesc <br /> within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ace <br /> data concerning himself. To exercise this righG an individual shall nodfy in wricing the responsible authoriry describing the nature of the disagreemenc. <br /> The responsible authoriry shall within 30 days eicher: (a)correct the dara found to be inaccurace or ineomplete and aaempc to nodfy past recipienu of <br /> inaccurace or incomplete data, including cecipiena named by the individual;or(b)nodfy the individual that he believes the data to be corcect. Data <br /> in dispute shall be disclosed only if the individual's sta[ement of disagreement is included wirh the disclosed data. <br /> The decerminadon of the responsible authoriry may be appealed punuanc to the provisions of the adminis�arive procedure act relating to <br /> contested 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 Ciry 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, 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, but refusal may require that the City deny the permit or license. <br /> 3, The information tnay be shared with other local, state or federal a�encies 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 ri�hts 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 /> � 1—� O✓r i� � �Gccr/�- I e� ��,�-� <br /> Fint /' �id�,/z� Lasc <br /> o�S�S� �� �o(��ti �c 1�-. % <br /> Address ) � `/�f� ,�'-S 3S� y'��—O c�'� <br /> (�-o�s �IC e <br /> C�ry $mce Zlp Phone <br /> I understand '�hts as stated above. <br /> Signantre <br />