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�. <br /> � <br /> Sec.13.04 RIGHTSOFSUBJECTSOFDATA <br /> Subdivision 1. Type ojdata 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. Injormation required to be given individuaL An irrdividual asked to supply private or confrdential data concerning himselj <br /> shall be informed of (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or stalewrde <br /> system;(b)whether he may refuse or is legally required to supp[y the requested data;(cJ n�ry known consequence arising from his supplying or <br /> refusing to supply private or conf:dential data;and(d)the rdentity of other persons or entities authorized by state or federal!aw to receive the data. <br /> This requirement shall not apply when an indivrdual is asked lo supp(y investigative data,pursuant to section 73.82, subdivision 5, to a law <br /> enforcement o�cer. <br /> The commissioner ofrevemre mav place the notice reouired under this subdivision in the indivrdual income tax or nronertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3.Access to data by individunL Upon request to a responsible authoriry,an indrvidual shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as public,privale or confidential. Upon his further requesl,an individual who is the <br /> subject of stored prrvate or public data on individuals shall be shown lhe data without a�ry charge to him and,if he desires,shal!be informed oj <br /> the conteret and meaning of that data. After an individual has been shown the private data and injormed ojits meaning,the data need not be <br /> disclosed to him for six months theseafter unless a drspute or action pursuant to this section is pending or additional data on the rndividua!has <br /> beere collected or crealed. The responsible authority shall provide copies of the private or public dala upon request by lhe individual subject of <br /> the data. The resporurble authorily may require the requesting person to pay the actual costs of making,cert�ing,and compi/ing the copies. <br /> The responsible authority shall comply immediately,rf possible,wilh any request made pursuant to this subdrvision,or within frve days <br /> of the date of the request,excludrng Saturdays,Sundays and[egal holidays,rf immediate comp[iance rs not possible. If he cannot comply with the <br /> request wrthin that time,he shall so inform the individual,and may have an additionalfive days within which to comply with the request,excluding <br /> Salurdays,Sundays and legal holidays. <br /> Subd.4.Procedute when data is not accurate or complete An individua!may contest the accuracy or comp[eteness ofpublic or private <br /> data concerning himself. To exercise thrs right, an individual shal!not�in writing the responsrble authority describing the nature ojthe <br /> disagreement. The responsible authorityshall within 30 days either: (a)correct the datafoernd to be inaccurate or incomplete and attempt to not� <br /> past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)not�the indrvidual that he believes the data <br /> to be correct. Data in dispute shall6e disclosed only if the irrdividual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions ojthe administrative procedure act relatrng <br /> lo contested cases. <br /> DATA PRIVACYADVISORY , <br /> In accordance with M.S.13.04,Subd.2,"Rights ofsubjects ofdata"we would Irke to rnjorm you that your requestfor a permit or[icense <br /> from the City of Orono or any oJits departments may require you to furnish certain prrvate or confidential information. <br /> You are notifred 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,bu!refusal may require that the City deny the permit or license. <br /> 3. The injormation may be shared with other/oca/,state or federal agencies to the extent necessary to process the permit or <br /> license. <br /> 4. I,f your requested permit or licerrse requires Council action to approve,some information may become public. <br /> S. You have certain rights under M.S. 13.04(see jollowing page)to review private data on yourself. <br /> 6. Your fu11 nam¢is required to process this application or permit. <br /> PLEASE PRINT <br /> � ► � � �01 vl G�f c.� .l�iL c� �-�1 <br /> First Middle Last <br /> Address <br /> City State Zip Phone <br /> 1 understand my rights as stated a ove. p <br /> igrratur <br /> � • <br /> 10 <br />