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� <br /> _ • � <br /> Sec.13.04 RIGHTS OF S[JBJECTS OF DATA <br /> Subd. 1. Type of data. 'Ihe rights of individual on whom the data is stored or to be stored shall be as set focth in this secdon. <br /> Subd.2. Information req�rired to be given individual. An individual asked to supply private or confidenual data conceming himself shall <br /> be informed of: (a)the pucpose and intended use of the requesud data widvn the collecting�tate agency,political subdivision,or statewide system; <br /> (b)whether he may refuse oY is legaily required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidenaal data;and(d)the idenriry of o[her persoas or endaes authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to suppiy invesdgadve data,pursuanc to section 13.82,subdivision 5,to a law enfarcement o�cer. <br /> The commissioner of revenue mav alace the nodce required under this subdivision in the individual income tax or nroaem taz refund <br /> instrucrions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request W a responsible authoriry,an individual shall be informed whether he is the subject <br /> of stored data on individuals,and whe[her it is class�ed as public,private or confidentiat. Upon his further request,an individual who is the subject <br /> of stored private or pubiic data on individuals shall be shown che 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 private data and informed of its meaning,the data need not be disclosed to him for <br /> six months thereafter unless a dispute or acrion pursuant to this secrion is pending or addidonal data on the individual has been collected or created. <br /> The responsible authoriry shall provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual cosu of making,certifying,and compIling the copies. <br /> The responsible authority shail comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot comply with the request <br /> within that rime,he shall so inform the individual,and may have an addidonal five days within which to comply wirh 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 public or private <br /> data concerning himself. To exercise this right,an individual shall nodfy in writing the responsible authority describing the nature of the disagmement. <br /> The responsible authority shali within 30 days ei[her: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of <br /> inaccunte or incomptete data, including recipients named by rhe individual;or(b)notify the individual that he believes the data to be correct. Data <br /> in dispute shall be disclosed on(y if the individual's statement of disagreement is included with the disclosed data. <br /> The decermination of the responsible au[horiry may be appealed pursuan[to the provisions of the administradve procedure act relaang 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 fumish 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 /> g. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. <br /> (. Your full name is required to process this application or permit. <br /> � � � �e� <br /> F�� Middle Last <br /> �7C� ��'� �- ���-Vr-P <br /> Address /rn , / 2 [L— � / • <br /> �V l�/ J T <br /> Ciry State Zip Phone <br /> I under tand my rights as stated ab ve. <br /> Signacure <br />