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r <br /> Sec.13.Od RIGHTS OF SUBJECTS OF DATA <br /> Subd. I. 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 confidential dataconceming himselfshall 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 supply <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 individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement otticer. <br /> The commissioner of revenue may_pllce the notice required under this subdivision in the individual income ta�or propertv tax refund <br /> instructions instead of on those fonns. <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�vliether it is classified as public,private or contidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown tl�e data without any charge to him and,ifhe desires,shall be informed of the content and <br /> meaning of that data. After an individual has been shown the private data and infonned of its meaning,the data need not be disdosed 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 die private or public data upon request by the individual subject of the data. The responsible audioriry <br /> may require the requesting person to pay the actuai costs of making,certitying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant ro this subdivision,or within tive days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that[ime,he shall so inform the individual,and may have an additional tive 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 of public or private data <br /> concerning himself. To e�ercise this ri�ht,an individual shall notity in writing the responsible authority describing the nature of die 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)notily the individual that he believes the data to be correct. Data in <br /> disp�!!e shall be disclosed only ifthe individual's statementofdisagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADV[SORY <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to infomz you that your request <br /> for a pecmit 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 /> l. The information you furnish will be used to detercnine 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 pennit 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 rec�uested permit or license requires Council action to approve, some infom�ation may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04(available upon request)to revie�v private data on yourself. <br /> 6. - Your fuil name is required to process this application or permrt <br /> �-„� � �� � � ��.� � �' <br /> �"t S � . C; j i � e:._. , 't G �/�� L�L��. �_ <br /> First � Niiddle _ Last <br /> �; ��� ; . ;'�-� �� � �jlL/ � � �r <br /> Address <br /> � , <br /> ��—J ��l l��.' !f� l� G� �'7�!/ /.�%` �/ 'J` ������ <br /> Cih� State Zip Phone <br /> I understand my rights as stated above. � <br /> �i/� - , �;��� �. '��-- <br /> �/ �� <br /> SignAtura � <br /> \ <br /> Reset Form �� <br />