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Sec.13.0,i RIGHTS OF SL'BJECTS OF DaTA <br /> Subd. t. Tvpe of daca. 'Ihe righc�of individual on whom[be data is stored or m be scorcd shall be as sec focth in[his secrioo. <br /> Subd.?. Informaaon reqirired to be�ven individual. �1n individual bsked ro suppiy privatr or confidenrial data concerning himsclf shall <br /> be informed of: (a)[he purpose and inrrnded use of the requesud dard wichin che collecring§t3ce agency, polidcal subdivision,or scitewide ryu:m: <br /> �b)whecher he may r.fuse or is(e3ally requir�d ro suppty the Rquesud dat�;(c)aay lmown coasr�Neace arisin3 from his supplying or refusing co supply <br /> privace or conndendal dara;and(d)[he idenacy of other persoas or enaaes auchorized by stac:or fedzral law to receive che dacs. This requiremeac shall <br /> not app(y whzn an individual is asked to supply in��esri¢arive data, pursuanc�o secrion 13.82, subdivision 5, to a law enfoczeatnc officer. <br /> The commissioner of r�enu r-iav plz- the noac- rauired under this subdivision in the individual income tax or proo�m raz refur.d <br /> instrucdons ins:e�d of on chose forms. <br /> Subd. 3. access to data b�individual. [ipon requesc to a responsible au�horiry,an individual shall be informed whecher he u tfie subjecc <br /> of scor=d dan on individuals,and whe:her ic is ci�ssified as pubiic, privace or coniidendal. lipon his furcher request,an iadividual who is the subjecc <br /> of stord priva�e or public dam on individuals shall be shown[he dara wichout any charge to him and,�if he desires, shall be iruormed of[he concent <br /> ar.d meaning of�hat dara. Aher an individual h�s been shown[he priva[e dara and informed oi iu meaning,�he data need noc be disclosed m him for <br /> six monchs cher_aiter uriless a dispute or acrion pursuan�tn chis secdon is pending or addidooa!data on the individuai 6as beea coilected or creaced. <br /> The responsibla au[horiry shall provide copies of diz privace or public data upon request by the individual subjecc of�he daca. Tne responsible auchoriry <br /> may requir[he requesring person ro pay the acaial cosu of making.cerdfying,and compiling rhe copies. <br /> 'Ihe responsible auchoriry shall compiy immediacety, if possible, wi[h any request madt pursuant co rhis subdivision,or within five days oi <br /> the dace of rhe requesc,excluding Sacurdays,Sundays and legsl holidays,if immediace compliance is noc possible. If he cannot comply with the reques� <br /> wichin chac[ime,he shail so inform[he individual,and may have an addiaonal five days wi[hin which to comply wi[h the tequest,excluding Saturdays, <br /> Sundays and legsl holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individua(may contest the accucacy or compleceness oF public or private ' <br /> dara cor.ceming himself. To exer.ise this right,an individual shall noafy in wridng rhe responstble auchoriry dzscribing che nacu:e of the disagreemeac. . <br /> The responsible au�horiry shall wi[hin 30 days ei�`.er: (a)correct[he data found ro be inaccurace or incomplece and aaempe to norify past recipiencs of <br /> inaccurace or incomplece dara, inciuding recipiena named by che individual; or(b)¢odfy d:a individual thac he believes the dara to be correcc. Dara <br /> in dispuce shall be disc!osed only if�he individual's sacement of disagreemen�is ir.cluded wi�h the disclosed dara. <br /> The de�erminadon of eha rzsponsibte auchoriry may be appealed pucsuanc co the provisions of the adminis�arive procedure act relaring [o <br /> contested cases. <br /> DAT� PRIVACY �DVISORY <br /> In accordance wich M.S. 13.04, Subd.2, "Ri�hts of subjecu of data", we would like to inform you tha[your reauest <br /> for a perm.it or license from the Ciry of Orono or any of its departments may require you to fumish certain private or <br /> confiden�ial information. <br /> You are notified that: <br /> 1, The information you furnish will be used to determine your qualification for the permit or license requested. <br /> ?. You may refuse to supply da�a, buc refusal may require thac the City deny the permit or license. <br /> 3, The information may be shared wich orher local, sca[e or federal a�encies co the extent 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 cenain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. <br /> (. Your full name is required to process this applicacion or permit. <br /> �, ,� ►` ,�"�: J-,� <br /> � � Lasc <br /> First �tiddlt <br /> , <br /> /��7 � l.-� � .,.��-- l� C� <br /> �ddrss - - <br /> , �.. <br /> j1'!r� J1S`i I =t-C'`�_ � '- f <br /> ���� - <br /> Ciry Sace Zip PFonz <br /> I understand my righu as staced above. . <br /> f <br /> , / <br /> �� � <br /> Signantsr <br />