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� <br /> Sec.13.0.3 RIGHTS OF SUBJECTS OF D�T.� <br /> Subd. 1. Tvpe of data. The righa of iadividual on whom[he data is scored or to be scored shall be as set forth in chis secrion. <br /> Subd.'_. Information reqirized to be�ven individval. a.n individual uked to suppiy private or confidenriai dara concerning himself shall <br /> be informed of: (a)the purpose and inr:aded use of che requcsted data within rhe collecang'stare agency,polirical subdivision,or sratewide rystem: <br /> (b)whether he tnay refuse or is legally required ro supply[he ctquested dan;(c)any Imown coasequence arising from his supplying or refusing ro suppiy <br /> privace or conndendal data;and(d)the idzarity of ocher persons or enrides auchorized by stace or federal law to receive the daca. This requiremen�shall <br /> noc apply wh�n an individuai is uf:ed to supp(y in�'esrieadve dam, pursuanc to secaon 13.82, subdivision 5, [o a law enfoccemen[officer. <br /> The commissioner of re�e�u riav pia-� [he nodc- roauired under[his subdivision in the individual income rax or propem raz refur.d <br /> inscrucdons instzad of on chose forms. <br /> Subd. 3. Access to data b�iadividuaI. tipon request to a responsible au[horiry,an individual shall be informed whether he is the subject <br /> of scor_d data on individuals, and wherher it is ctsssified as public, private or confidendal. lipon his funher request, an individual who is the subjecc <br /> of scord private or pubtic dan on indir�iduals shall be shown che da[a wichout any char3e to him and,�if he desires, shall be iniormed of the concenc <br /> and meaning of chat data. After an individual has been shown che privace data and informed oi its meaniag,the data need not be disclosed m him for <br /> six monchs chereaiter unless a dispuce oc acrion pursuanc to [his secrion is pending or addiaooal dan on the individual has been coilected or creaced. <br /> The responsibie au[horiry shall providz copies of dzz privace or public data upon request by the iadividuai subjecc of che daca. Tne responsible authoriry <br /> may require[he requesting penon ro pay che acaial cosrs of making,cerrifying,and compiling che copies. <br /> The responsible auchoriry shall comply immedia[ely, if possible, wich any request made pursuanc to this subdivision,or wichin five days or <br /> the dacP of the request,excluding Samrdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannoc comply with the request <br /> wi[hin chat time,he shall so inform[he individual,and may have an addidonal five days wi[hin which co comply with[he request,exc(uding Saturdays, <br /> Sundays and legsl holidays. <br /> Subd.4. Procedure when data is aot accurate or complete. An individual may contest the accuracy or compleceness of public or pri�•ate ' <br /> daca concerning himself. To exercise c,his righc,an individual shall nodfy in wriring�he responsible auchoriry describing�he nacu:e of the disagreemenc. . <br /> The responsibie auchoriry shall within 30 days ei[t:er: (a)correct the dara found to be inac:ura[e or incomple�e and aaempe to nodfy past recipiena of <br /> inaccurate or incomplete data, including recipiena named by [he individual; or(b)noafy cl:e individuai thac he believes[he dara to be correct. Data <br /> in dispute shall be disc:osed only if�he individual's stacemenc of disagreement is included wich che disclosed data. <br /> The deserminaaon of the rtsponsible auchoriry may be appealed punuanc to the provisions of che admuusaarive procedure act reladng to <br /> contes�ed cases. <br /> DAT� PRNACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "RiQ.hts of subjects of data", we would like to inform you that your reauesc <br /> for a permit or license from the Ciry of Orono or any of ics departments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1, The information you fumish will be used to determine your qualification for the permit or license requested. <br /> 2. You may refuse to supply daca, buc refusal may require tha� the Ciry deny the permit or license. <br /> 3. The information may be shared with other local, stace or federal agencies to the extenc necessary to process <br /> the permit or license. <br /> �. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> �, You have certain ri�hts under N1.S. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is required to process this applicacion or permit. <br /> ,� �1/L�1L's L:� <br /> �tlddlz Last <br /> Fint � <br /> �� �G ��� � � <br /> Addre+ss ,�� `'�(� �� �J,� I� ��� �—L��� <br /> �--C./ =-�l I � <br /> Ciry Stace Z�p Phone <br /> I unde d y ri;hts as stated above. <br /> � �� — <br /> Signature <br />