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r ti Sec.13.04 RIGHTS OF SUB.TECTS OF DaT?. Subd. 1. Tvpe of da[a. The righ�s o[iadividuai on whom the dan is scored or ro be scorcd shall be as set for[h in chis section. Subd."_'. InformaGon reqirired to be�ven individual_ ,an individual asked ro suppIy privare or confideurial dara concerning himself shall be informed of: (a) the purpose and inunded use of che requested daca wichin�he collecang"sam agency, poliacal subdivision,or sratewide rystem: �b)wheu'�er he may refuse or is legally required ro suppty the requested data:(c)any lmown wau4uence arising from his supptyiag or refusing co supply priva[e or coni:dendal data:and(d)[he idenaty of ocher peaoas or enudes auchorized by ssa�.or fedzral law to re�eive[he daca. 'Ihis requir:menc shall not apply when an individual is asked to s�pply in��esri¢adve daa, pursuan�[o secrion 13.82, subdivision 5, to a law enforcecaent officer. 'I1te commissioner of r e�u nav pla- the nodr r-auired under�his subdivision in [he individual income_tax or proPem taz refur.d inscrucdons instead of on chose forms. Subd. 3. Access to data bp iadiriduaI. lipon rcquesc co a responsibte auchoriry,an individual shall be informed whe�her he is the subjecc of scnrd daca on individuals,and whe:her i[is clusified as public, privace or confidendal. L;pon his further request,aa individual who is the subjecc of stord privace or public daci on indi�•iduals shall be shown ctre dara wirhout any charge cD him and,�if he desires, shall be iniormed of[he coacenc and meaniag oi chac dara. After an individual has 6een shown che privac�dara and informed oi iu meaniag,[he daca need no�be disclosed co him for six mon�hs chereaiter unless a dispute or acrion pursuanc co �his secrion is pending or addidooal dara on the individual has bzen collecud or creaced. 'Ihe responsibiz auchoriry shali provide copies of d1e priva�e or public data upon reques�by che individual subjecc of the daca. Tae responsible auchoriry may rquire che requesring person ro pay the acnial cos�s of making.cerafying,and compiling[he copies. The responsiblz authoriry shall comply immediately,if possible,with any request made pursuant co this subdivision,or within five days of the dac:of tf:z requesc,ezeiuding Sacucdays,Sundays and legai holidays,if immedia[e compliance is no�possible. If he cannoc comply with[he requesc within rhac dme,he shail so inform che individual,and may have an addidoaal five days wichin which to comply wi[h[he request,exduding Sacurdays. Sundays and legsl holidays. Subd.4. Procedure when data u not accurate or complete. An individual may concest che accuracy or comp(eceness oF pubiic or pri�•ate ' data conceming himself. To exercise chis righc,an individual shall noafy in wridng�he responsil�le auchoriry describing rhe nacure of the disagreemeac. .. The responsible authoriry shall within 30 days ei�':er. (a)correcc[he data found to be inac:urace or incomplete and attempt to nodfy past recipiencs of inaccursr or incomplete da[a, ineiuding recipiena named by che individual; or(b)norify [he individual thac he believes [he dara to be correcc. Data in dispuce shall be disc:osed only if the individual's sra�ement of disagreement is ir.cluded wich[he disclosed dara. The decerminaaon of thz responsible auchoriry may be appealed pursuanc to the provisions of the adminis�arive procedure act reladng to contested cases. DAT� PRIVACY �DVISORY In accordance with M.S. 13.04, Subd.2, "Ri�ts of subjects of data", we would like to inform you tha[your reauest for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or confiden�ial information. You are notified that: 1. The information you fumish will be used to de[ermine your qualification for che permit or license requested. ?. You may refuse to supply data, buc refusal may require that the Ciry deny the perm.ic or license. 3, The information may be shared with o�her local, stace or federal a;encies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5, You have certain righcs under ;�1.5. 13.04 (available upon request) to review private data on yourself. (, Your full name is required to process this applicacion or permit. First �iiddlt Last � ?�ddress Ciry � , ^ Snte Zip Phona �/� I un�ecst � �ri�ts as sta[ed aoove. , � r� ��b� \-Sig nt