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�� . <br /> Sec.13.04 RIGHTS OF SIJB.JECTS OF DATA <br /> Subd. 1. Type of data. 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. Information required to be given individual. An individual asked to supply private or confidendal data concerning himself shall <br /> be informed of: (a)the pucpose aud intended use of the requested data within the collecting'state agency,political subdivision,or statewide system; <br /> (b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or�efusing to supply <br /> private or confidendal data;and(d)the identiry of other persoas or en[iaes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigadve data, pursuant to section 13.82, subdivision 5,to a law enforcement c�fficer. <br /> The commissioner of revenue maY place the notice required under this subdivision in the individual income taz or propertv tax refund <br /> instructions instead of on those fornts. <br /> Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shail be informed whether he is the subject <br /> of stored data on individuals,and whether it is classified as public, private cr cod�fiden[ial. Upon his further request,an individuai who is the subject <br /> of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be infoaned of the content <br /> and meaning of chat data. After an individual has been shown the private data and informed of iu meaning,the data need notbe disclosed to him for <br /> six months thereafrer unless a dispute or acdon pursuant to this secdon is pending or additional data on the individual has been coilected or created. <br /> The responsible authoriry 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 requesting person ta pay the actual cosu of making, certifying, and compiling ttze copies. • <br /> The responsible authority shall comply immediately, if possible, with any request made pursuant to this subdivisir�n,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal hoiidays,if irnmediate compiiance is not possible. If he 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 eomply 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 aublic or private <br /> data concerning himself. To exercise this right,an individual shall noqfy iu wridng che responsible authority describing the nahire of the disagreement. <br /> The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt te nodfy past recipients of <br /> inaccurate or incomplete data, including recipients named by fhe individual;�r(b)notify the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed only.,if the individual's statement of disagreement is included with the disclosed data. <br /> The de�erminadon of the responsible authoriry may be appealed purSuant to the provisions of the admuustrative procedure act relating to <br /> contested cases. <br /> DATA PRTVACY ADVISORY <br /> In accordance with M.S. 13.04, Sub�.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 dep�nments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The informatian you furnish will be used to determine your qualification for tLe permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the pernut or licease. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to process <br /> the permit ar license. <br /> 4. If your requested percnit or ]icense 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�ermit. <br /> �� ,� .��^�,-y �'�,.�,��� _ <br /> � � . G�- <br /> Fi t Middle � Last <br /> �/��� �X�..� ��' o R 1�� v�� <br /> Address 1� �' <br /> � �,�,,,�,"� �c�l i"\ �L1/'� �S �/.� , �=.�`��� <br /> �i�, State � Zip Phone <br /> I understand my rights as stated above. <br /> _._ _ _..... <br /> _ _ . <br /> / _..... _ ......._ . <br /> '� .. . .. <br /> �y 7�r, ,.�� <br /> Signamre . U . _ <br />