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Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. l. Type of data. The righu 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 conceming himself shal I be <br /> informed of: (a)the purpose and intended use ofthe requested data within the collecting 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 suppty <br /> private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shal I <br /> not apply when an individua]is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav place the notice required under this subdivision in the individua]income tax or Rropertv tax refund <br /> instructions 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 data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and <br /> meaning ofthat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual costs of making certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional 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 ofpublic or private data <br /> conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature ofthe disagreement The <br /> responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative 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 City of Orono or any of its departments may require you to furnish 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 <br /> 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 <br /> process the permit or license. <br /> . 4. If your requested permit or license requires Council action to approve,some information 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 rocess this pplication or permit. <br /> ��1 S c ,c n �' <br /> First ��� � � ���d�e � + Last <br /> � <br /> Address r <br /> � o � i � l'� jl �'� ac� <br /> C��Y State Zip Phone <br /> I understand my rights as stated above<�—J V <br /> / <br /> S' ure <br /> '�? � �'��� ���� � <br /> s��� ,r � �� g � ��, , 32 <br /> � ,� , � <br /> y <br /> Y, .��',d -3 ,�5; �.v <br /> >..,, �_ . u.,, dst n��_'�'4'....:..:�` a .f <br />