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Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type oC data. The ri$h�t of ir.dividuai on whom che data is scoccd or to 6e srnr:d s�ll be u set[o�in this secdon. • Subd.2. InformaGon reqtrired to be gvea individual. An individual uYed to suppiy privatt or confideadal data concerning himself shall be iefarmed of: (a) th� purpose aad inc:aded use of the rsquuc�data within the callecdng State agency, polidcal subdivisioa,or stacewide rystem: (b)whecher he may rfuse or is le3ally requtr_3�o supply the r:quesced dae:(c)any�mown coasequeuce arising[com his supplying or refusing to supply p;ivace oreor9denri�!dzra;az:d(d)ehe ideeriry of oche.r pecsoas or enriri:s auchociz:d by sc�ee or fed:cal law co receive the daca. This requ�remeacshall _ no�apply when an individual is as4:ed to supply invesdgadve daea,pucsuan�co secaon 13.83,subdivision 5, to a law enforcemeat offceer. The eom�.ission:r of cevenue mzv olace the noace reauird und-r this subdivision in the individual income Cix or orooem mt refued ins:rucdor.s insc=ad of on chose forms. Subd. 3. Access eo data bv indi�idual. lipan rcqucs�en a responsible auchoriry.an individual shall be informed whe�her he is the subject of smred dae on individuals,and whecher ic is classified u pubiic, privace or confidenaal. Upon his fuc�e�cequest,an individual who is the subjecc af scor:d privace or public daca on individuals shall be shown che dac�wichoue any charge to him and;if he desires, shall be infoaned of ehe concen� ar.d m�aning of that dara. Aftcr an individual hu been shown ehe priva�:data and informed of ict meaning. the dara need not be d'uclosed to hua for siz monchs tl:ereaiur uriless a dispu�e or acdon Qucsuanc to ehis secdon is pending or addirioaal dan on ehe individual has beea eollecad or ereared. The r_sponsibl:authoriry shall provide capies of che privac�or public data upan cequesc by che iadividu�sl subjecc o[�tie data. The responsible auchoriry msy cequire the rcquuang ptaon to pay the acaial coscs of m3king,ccrrifying,and compiling che eopies. 'Ihe r.spansible auchoriry shall eonply inmediately,if possible, wich any reques�made pursuant to chis subdivision,or within five days of the dac:of the requesc,ezcluding Sacurdays,Sundays and Icgal holidayt,i(immediace compliance is not possible. If he cannot comply with�he tequest wi�hin that drae,he shall so inform the individual,and may have an addiaonal five days wichin which to comply wi�h the requesc,excluding Sa0.ttdzyso Sundays and legal holidays. Subd.4. Procedure wh�n data�s not accurate or complete. An individual may contesc the accuracy or eomp[eteness of public orpcavate dan concernirsg hirrsel(. To exer:ise chis n¢t;c,an individual shall nod"ry in wridng�h:responsibte authoriry describing the nanire of the disagreemeaG The responsible authoriry shall wi�hin 30 days ei�her: (a)corr_cc che data four.d to be inaccunce or incomple�e u:d aaempt co nodfy past recipieau of iraccunce or incomplec�data, including re:ipiencs nars::d by che individ�al; or(b)nodfy che individual that he believes�he da�a to be eocrect Data in dispu�e shalt be disdos:d only if che ir.dividual's sat:m:at o!disagreer,.ent is included with the disdosed da�. The decerminadon of the responsible au�horiry may be appealed pursuanc to ehe provisions of the admuusaaave p�aceduce act reladng eo eon[esctd eases. DATA PRIVACY ADVISORY � � In accordance wich M.S. 13.0�, Subd.2, "Rights of subjeccs of data", we would li.tie 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 confideatial informa�ion. You are notified that:• _ 1. The information you fumish will be used to deteimine your qualification for the permit or licease requested. 2. You may refuse to supply data, bu[ refusal.may require that the City deny the pe[mic or licease. 3. The information may be shared with ocher local, state or federal a;encies to the�extent necessary to process � the permit or license. 4. If your reques[ed permit or licease requcres Council acttbn to approve, some information may become public. 5, You have certain ri�hts under N1.S. 13.04 (available upon request) to review private data on yourself. 6, Your full name is required to process this application or permit. � ��It'�l`�� l L � � �L S ��I�-� . First �Siddle �c �� N��Y��o� ��4� Add«u � L i,�� s�.�.3 I �-�� ��v�-'�' - Ciry Sace Zip Phoae . . I underst y ri;hu as stated above. , � , � - , � L� Signan:re