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• <br /> 4 <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 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 data concerning himself shall <br /> be informed of: (a)the purpose and 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 refusing to supply <br /> • <br /> . _private orconf.dernal data;and(d)the identity of other persons or eaddes authorized by state or fede 2i inw to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigative data.pursuant to section 13.82.subdivision S,to a law enforcement officer. .• •• • <br /> The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,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 conF.dendal. Upon his further request,an individual 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 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 action pursuant to this section is pending or additional data on the individual has been collected or created. <br /> The responsible authority shaliptovide copies of the private or public data upon request by the individual subject of the dam. The responsible authority <br /> may require the requesting person to pay the actual costs of making.certifying,and compaing the copies. <br /> The responsible authority shall 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 immediate 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 additional five 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 orprivate <br /> data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. <br /> The responsible authority 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)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 determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to <br /> contested cases. ' . • . <br /> PATA 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 /> 'S. 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 /> .�-�— • <br /> �c s 7 et -3 q� Ls o n <br /> lice• n <br /> D4 O1` MiddleGtr Last <br /> Add ` Ot A\u / T i • <br /> City State J Zip Phone <br /> • <br /> I underst m rights as s -ted bo <br /> • <br /> Signant <br />