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��. . � . � , - , Sec.13.04 RIGHTS OF SUBJECTS OF D?,T?a Subd. 1. Type of data. The righ�s of individual on whom the dara is scored or to be swred shall be as set forch in this secaon. - Subd.2. Information req�red to be given iadividual. .1n iadividual asked to suppiy private or conhdenaal data concerning himsdf shall bt iaformed of: (a)the purpose and iac.nded use af che requesr�data wichin the eollecdag�tate agency,polidcal subdivision,or sntewide rystem; (b)whaha he may ctfuse or is legally nequir_d to supply the tequested dat;:(c)any]rnawn coasequeace arising ftom his supplying or refusing to supply privace or eonndendal dara;and(d)che idendry of other persoat or enad�s aachorized by scate or federal law to receive the dara. 2his requirement sSall noc apply when an individual is asked to suppty invesrigarive dam,pursuan�to secdon 13.82,sutidivision 5.to a law eafoccement o�cer. � � The eommissioner of revenue mav olace che noace r-auired und-r this subdivision in the individua! income tax or orooerev aa refund inscrucdons inscead of on chose focros. . Subd.3. Access to data by indiridual. Upon request to a responsible au�horiry,an individual shall be informed whe�her he is che subject � of scored dati on individuals,and wherher ic is clusified as public,Qrivate or conFdendal. Upon his furcher requese,aa iadividual who is the subjecc af stored piivate or pubtic dam on individuals shall be shown the dara wichout any chacge ta tiim and;if he desires,shall be infocmed of the coatenc and meaning of that dara. Aher an individua!has been shown[he private data and informed of iu meaning,the dara need not be disclosed m him for six moncfLs chereaiur untess a d'upute or acaon pursuanc to chi.s secaon is pending or addidonal data on the individual hu been collected or creaud. The rosponsible authoricy shall pcovide copies of the privace or public da�a upon cequese by�he individua!subject of ehe dara. 'Ihe responsible auchority may tequire the requesring person to pay the actual coset of making,ce�tifying,and compiling the copies. The responsible aurhoriry shall comply immediately,if possible,wieh any requesc made pursuant to chis subdivision,or wi�hin five days of the date of�he request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request wirhin that time,he shall so inform the individuat,and may have an addidonal five days within which to compty wieh the request,exctuding Saturdays, Sundays and legal holidays. Sabd.4. Procedure whea data u not accurate or complete. An individual may contestthe accuracy orcompteteness of public arprivate data concerning tianself. To ezereise this right,an individual shall nodfy in wridng�he respocssible suthoriry dtscribing the naaire of the disagreement Zhe responsible au�horiry shall withict 30 days either: (a)correct[he data found to be inaecurate or incomptete and attempt W nodfy past reeipiena of inaccurate or incomplete dara, including recipient�named by the individual:or(b)nodfy the individual that he believes che data to be cocrect Data in dispute shatl be disc(osed only if the individual's statemenc of disagreemcnt is inctuded with che disciosed data. The determinadon of the responsible au�t►oriry may be appealed punuant to the provisions oF the admirusaarive procedure act relating to contested ea.ses. DATA PRIVACY ADYISORY � In accordance with M.S. 13.04,Subd.2, "Rights of subjects of data", we would like to inform you that your request for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or confidential information. You ue notified that:• 1. The infocmation you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shued with other local, state or federal agencies to the extent necessary to process ' the permit or license. 4. If your requested permit or license requcres Council action to approve, some information may become public. 5. You have cenain ri¢hts under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full nazne is required to process this application or permit. � ��1 0 � �C�►�t�(�12�/Z . Fint biiddle Luc �q/�1��i�'�,,��1'U t� Add � �(�/� � • � 9J � � Ciry Snte Zip Phoae I underst my ' cs as stated abov . (�'Y1'► ,.-,_.�� Signamte .