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� <br /> Sea 13.04 RIGHTS OF SIJBJECTS OF DATA <br /> Subd. 1. Type of data. The righcs of individuat on whom che data is stored or to be swred shall be as set forth in this secdon. <br /> Subd.2. Information nq�rired to be given individual. An individual asked to supply private or confidential data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requesred data within the collecting State agency,political subdivision,or stacewide system; <br /> (b)whether he may refuse oti is legally required to supply the csquesud data:(c)any laiown consequence arising from his supplying or refusing W supply <br /> private or confidenrial data;and(d)the idenriry of other persons or enddes auchorized by state or federat law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply invesdgadve data,pursuant to section 13.82,subdivision 5,to a law enforcement o�cer. <br /> The commissioner of rovenue mav place the notice rewired under this subdivision in the individual income_taz or oroDem taz refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible au[hority,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject <br /> of stored private or public data on individuals shall be shown ehe data wi[hout any charge to him and,'if he desires,shall be informed of the content <br /> and meaning of that data. After an individual has been shown the privace data and informed of iu meaning,rhe data need not be disclosed to him for <br /> six months thereaCter unless a dispuu or acdon pursuanc to this secaon is pending or addirional data on the individual has been coliecud or created. <br /> The responsibie authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry <br /> may require the tequesting person to pay the actual cosu of making.certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any requesc made pursuant to chis subdivision,or within five days of <br /> the date of rhe request,excluding Saturdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legat holidays. • <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private <br /> dara conceming himself. To exercise ehis right,an individual shall nodfy in writing the responsible authority describing the nacure of rhe disagreement. <br /> The responsible authoriry shall wi[hin 30 days either: (a)correct the data found to be inaccurate or incomptece and attempt to nodfy past recipienu of <br /> inaccurate or incomplete data, including recipienrs named by the individual;or(b)notify the individual thac he believes the dara to be correct. Data <br /> in dispute shail be disclosed only if the individual's stacemenc of disagreement is included with[he disclosed data. <br /> The determinaaon of the responsible aurhoriry may be appealed punuanc to the provisions of che administradve procedure act rela6ng to <br /> contesud 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 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 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 process this application or permit. <br /> .�0 /�/AJ � 1� Lc/LO�t� <br /> Fint Middle Last <br /> oo�oJ" /� .s/�� ��' <br /> Address <br /> Q�� �✓D /k/✓ .S�S.7y/ �y��.T 3/a 5� <br /> City Sta[e Zip Phone <br /> I understand my 'g ts as state bove. . <br /> _��� <br /> Signamre <br />