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� <br /> � <br /> Sec.13.0-1 RIGFiTS OF SLJBJECTS OF DaT.� <br /> Subd. 1. Tppe of data. The righ�c of individual on whom the dara is stor-3 or ro be stored shall be as set forch ia this secaon. <br /> Subd.2. Intormation reqiric�ed to be given individual. �1n ir.di�idual asYt3 w supply privare or confidendal data concerning himseif shall <br /> be informed of: (a)ehe purpose and incended use of the reques�ed dan wi�ia the eollccang Ecace agency,polidcal subdivision,or sratewide rystem; <br /> (b)whec'�er he may refuse oY is legally required to supply[he requested dan:(c)any l�own eonsequence arising from his supplying or refusing to supply <br /> priva�e or conndenaal data;and(d)the idendry of other peaoas or enddes aechoriz:d by sute or federsl taw to receive th�data..This requiremen�s6a11 <br /> no[appiy when an individual is asked to supply investigadve daca,pun�^c to seccoa 13.82,subdivision S,to a.law enforcemenc o�cer. <br /> '!he commissioner of reverme mav place the nodce tewircd erd•r this subdivision in ihe individual income tax_or�roaem tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by iadi�idual. Upon requesc to a r_swasible aechoriry,an individual shall be informed whether he is the subject <br /> of swred data on individuals,and whecher it is classificd as public,privau,or confider.aal. Upon his further request,an individual who is the subjec[ <br /> of scorni privace or public dara on individuals shall be shown che data wiu out any e'narge to him and;if he desires,shall be informed of rhe coacent <br /> and meaning of chat daca. Afttr an individual has been shown[he priva��an and in:ormed of ics meaning,che dara need not be disclosed to 6im for <br /> six monchs chereaiser uniess a dispute or acdon pursuanc to ehis secdon is tiending or addidonal data on the individual has been collecced or creaced. <br /> The responsibl�au�horiry shali provide copies of the private or public dac�c�on requ�:by[he individual subject of�he data. The responsible authoriry <br /> may rquire che requesdng person to pay ehe acaial cosu of makin¢,ce.^:;ing,and compiling the copies. <br /> 'Ihe responsible auchoriry shall comply immediatety,if possibl=,wich any r_quest made pursuant ta this subdivision,or wichin five days of <br /> the dace oP che reques�,ezcluding Saairdays.Sundays and legal holidays,ii is.mediac-compliance is not possible. If he cannot comply with the requesc <br /> wichin chac ame,he shall so inform che individual,and may have an addicer.al five days wiehin which to comply with che request,ezcluding Satucdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data ss not accurate or comptete. An indiviZual may contest the accuracy or complemness of public or pri�•ate <br /> dan concerning himself. To exercise this rieht,an individua!shalt nodfy ia wriang c:s responsible authoriry dascribing�he nacure of the disagreemenc. <br /> The responsible authoriry shall wichin 30 days either: (a)correct[he dae fcund to be inaccuratc or incomptete and attempc to nodfy pasc recipiencs of <br /> inaccuh�e or incompiete data, inciuding recipiencs named by the individi:al;or(b)�odfy the individual thac he believes the dara to be coaecc. Da�a <br /> in dispuce shall be disclosed only if the individuai's sta�emenc of disagrr_�ent is�.clnded with the disclosed data. <br /> The decerminaaon of the rasponsible authoriry may be appea�ed punuac�to the provisions of che adminisaarive procedure act relaring to <br /> contes.ed cases. . <br /> DATA PRIV:�CY ADVISORY <br /> In accordance wich M.S. 13.04,Subd.2, "Rights of subjects of data", we would like to inform you that your reauest <br /> for a pemut or license from the Ciry of Orono or any of ia deparments may require you to furnish cercain priva[e or <br /> confidencial information. <br /> You are notified that: <br /> 1, The informacion you fumish will be used to de:ermine rour qualification for the permit or license requested. <br /> 2, You may refuse to supply data, buc refusal nay require that the City deny the permit or license. <br /> 3, The information may be shared with ocher loc�l, state or federal agencies to the excent necessary to process <br /> the permit or license. <br /> 4. If your requested permit or license requires Council action to approve, some informa[ion may become <br /> . . public. <br /> �, 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 aoplica[ion or permic. � <br /> J'C �� (�,OO (� � � � <br /> Finc � �fiddle Last <br /> L� �G 6 �XC��s i'o�' ��c-c.� <br /> Address ���' <br /> s T l.���5 ���� �� v►�► n 5--s���, �t.s�a - �s� 3 - � <br /> C`ry Sm� Zip Phone <br /> I understan my ri;hts s ed above. . <br /> � <br /> Signacure <br />