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� � <br /> ; <br /> Sec.13.0�1 RIGIiTS OF S[JB.TECTS OF DaT:1 <br /> Subd. 1. Type of data. "Ihe rights of ir.dividual on whom the data is scored or co be stored shall be as set forrh in this secdon. <br /> Subd.2. Information reqirired to be�ven individual. An individual asked to supply private or confidenaal data coocerning himself shall <br /> be informed of: (a)the purpose and in[ended use of ttre requested data within the collecdng'state agency,polidcal subdivision,or sracewide system; <br /> (b)whether he may refuse oY is legally required to supply the requested data;(c)any lrnown coas�quence arising from his supplying or refusing to supp(y <br /> privace or conndendal data;and(d)the idennry of orher persoas or entides authorized by state or federal law to receive the data. This requiremen[s6a11 <br /> not apply when an individual is asked to suppiy in��srieadve dara, pursuant to szcdon 13.82, subdivision 5, to a law enforcement officer. <br /> The commissioner of re�e�u mav pla-� tt� nodce reauired under this subdivision in the individual income tax or propem taa refund <br /> instructions instead of on[hose forms. <br /> Subd. 3. ?.ecess to data bp indi�zdual. liQon requesc to a responsible authoriry,an individual shall be informed whe[her he is the subject <br /> of stord data on individuals,and wheeher it is class��d as public, privace or contidenaal. lipon his further request, an individual who is the subjecc <br /> of stor.d privace or public dara on individuals shall be shown rhe data without any charge to him and, if he desires, shall be informed of the content <br /> and meaning of rhac data. Ahzr an individual has been shown che privace data and informed of ics meaning, the data need not be disclosed[o him for <br /> six mon[hs chereafrer unless a dispute or acdon pursuant to this secdon is pending or addiaooal data on the individual 6as been collected or creaced. <br /> The responsible au�horiry shali provide copies of che private or public dara upon request by the individual subject of the data. The responsible auchoriry <br /> may require the requesring person to pay the acatal coscs of making. cerafying, and compiling the copies. <br /> The responsible authoriry 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 compfy with the request <br /> wirhin chat time,he shall so inform rhe individual,ar.d may have an addidonal five days wichia which to comply with the request,exeluding Sacurdays, <br /> Sundays and legat holidays. <br /> Subd.4. Proeedure when data is not accurate or complete. An individua!may contest the accuracy or completeness of public or pri�•ate <br /> data conceming himself. To exercise[his rieht,an individual shall noafy in wridng the responsible authoriry describing the nature of the disagreement. <br /> The responsible authoriry shall within 30 days ei4`.=r: (a)correct the data found to be inaccurace or incomplece and attempt to nodfy past recipiencs of <br /> inaccurate or incomplete dara, including recipiencs narr.ed by [he individual; or(b)nodfy the individual that he believes the data to be correc[. Data <br /> in dispute shall be disclosed only if the individuai's sncemenc of disagreement is included wi[h[he disclosed data. <br /> The de[erminarion of the responsible au�horiry may be appealed pursuant to the provisions of the administrarive procedure act relacing to <br /> contested cases. <br /> DAT� 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 Ciry of Orono or any of its departmen[s may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish«�ill be used to determine your qualification for the pemut or license requested. <br /> ?. You may refuse to supply da[a, but refusal may require that the City deny the pemut 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 /> 5. You have certain rights under �1.S. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is required to process th;s applicacion or perm.it. <br /> ��l�i'J��'� 1�1�2fl� (�ll�Ll�"'.� �`���.�L <br /> First �ld�z Lasc <br /> iy(c (;� 'i�V�71, R"b�'� � �/\ <br /> � Addcess ��i ����� <br /> �/� ���/, 3ta[e Zip Phone <br /> Ciry <br /> I understand my ri�hts as stated abo��e. <br /> � � � <br /> Signantr <br />