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� � r� <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individual on whom the data is stored or oo be stored shall be as set forrh in d�is section. <br /> SS�bd.2. InformaHon required to be gtven midi�idual, pn individua!asked to supply privaoe or confidential dara concerning himself shall <br /> be infocmed of: (a)the puipose and inoe�ed use of the cequesoed data within the collecting state agency,po(iacal subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required co supply the�equested data;(c)any lmown consequence azising from his supplying or refusing ro supply <br /> private or confidenaal data;and(d)the idenaty of other pecsons or entities authorized by state or federal law ro receive the data. T'his requirement shall <br /> not apply when an individual is asked to supply investigaave data,pursuant to section 13.82,subdivision S,to a law enforcement officer. <br /> The commissio�r of ieveaue mav ol�e the�ace roouisd under this subdivision in the individual income taz or ocooertv tax refund ins�ucdons <br /> instead of on those forms. <br /> S�bd.3. Acc�to data by mdividual. Upon request ro a respoasible authority,an individual shall be informed whether he is the subject of <br /> sooted dala on IDdividuaLc,a�whed�er it is clasa6ed as public,private or confidenfial. Upon his fucther request,an individual who is the subject of stoied <br /> private or pubGc data on individuals shall be shown the data without any chazge w him and,if he desires, shall be informed of the wntent azid meaning <br /> of that data. After an individual has been shown the privau data and informed of its meaning, the data need not be disclosed ro him for siz months <br /> the�r unless a dispute or acCon pursuant oo this section is pe�ing or addiaonal data on the individual has been collected or created. The respoasible <br /> authority shall provide copies of the private or pubGc dara upon request by the iadividual subject of the data. The responsible authority may require the <br /> requesting pecson to pay the acwal costs of making,cerafying,and compiling the copies. <br /> The cssponable authority shall comply immediately,if possible,with any re.q�est made pursvant w this subdivision,or within five days of the <br /> daoe of the request,ezchul'mg Saaudays,�ndays a�legal holidays,if immediate compliance is not possible. If he cannot comply with the request within <br /> that ame,6e shall so info�m the individual,and may have an addidonal five days within which to comply with the request,exduding Satucdays,Suadays <br /> and legal hoGdays. <br /> �bd.4. Procedure whm data is not aaurate or oomplete. An individual may contest the ucuracy or completeness of public or private data <br /> conceming himxlf. To ezercise this right,aa individual shall nodfy in writing the responsible authoriry descnbing the nature of the disagreement The <br /> irspoa�ble suthority s6all within 30 days either. (a)conect the data found ro be inaccurnu or incomplete and aaempt ro notify past recipients of inaccurste <br /> or incampleoe data,�hrd'mg recipienu named by the individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall <br /> be disclosed only if the individual's statement of disagreement is included with the disclosed dara. <br /> The deoeiminaaon of the iespoasffile audwriry may be appealed Exxusvant to the provisions of the adminisuative proceduro act relating w contested <br /> cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, S�bd. 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 depaztments may require you to furnish certain private or <br /> confidential information. <br /> You aze 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 shazed 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 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 /> � ��� 'W� �iZ/�=�Z <br /> Ficst �Middle I,ast <br /> ��{�� �'lo��� 5 N4> �� <br /> Address <br /> City State Zip Phone <br /> I understand my rights as stated above. <br /> . � <br /> Si mn <br /> 10 <br />