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Sec.13.0-i RIGFiTS OF SUBJECTS OF DaT?, <br /> Subd. 1. Tvpe of data. The righcs of�dividual on whom the data is scored or m be stoRd shall be as set forth in chis secrion. <br /> Subd."_'. Informaaon reqirired to be�ven individual. ?�n individual asked co supply privare or confidendal daa coacerning himself shall <br /> be informcd of_ (a)[he purpose aad iar_aded usr of�hc requestr�data wishia[he colieccing'sara agency,polidcal svbdivision,or sracewide rystem: <br /> �b)whether he may r.fuse or is legatly requiied:o a:ppty thc requated data:(c)any Imown coascqueace arising from his supplying or refusing to supply <br /> priva[e or conndendal data:and(d)the idenrity oi o�er persoas or enriries auchoriz:d by scar_or federal law to rec:ive the dara. This requiremen�s6alI <br /> not appfy when an individual is asked to svpply s.ud¢a¢ve dam, punuanc ro secdon 13.82, subdivision 5, co a law enforcecaeac o�cer. <br /> The commissioner of rve�u� nav '---th- ro�c- rauired under this subdivison in [he individual income taz or prooem_taz_refur.d <br /> inscrucdons insrzad of on�hose forms. <br /> Subd. 3. ?,ecess to data b�individual_ lipon requesc to a responsible auchociry,aa individual shall be informed wheeher he is the subjec� <br /> of scor_d data on individuals,and whesher it is c?ssifed as public, priva[e or confidenual. i;goa his further request,an individual who is the subjecc <br /> of stord privace or public data on individuals s;.i:be showv�he da[a wict:ouc any char3e co h�and,-if he desires, shall be iniormed of the con[er.c <br /> and meaniag oi rhat dara. After an individua!h�s teen shown che priva[e daca and informed oi its meaaing,che data need noc be disclosed to him for <br /> siz monc,`is cf:eraner uriless a dispute or acrion r�_:susnc tn chis secrion is pending or addicoa�l daca on che individual has bzen collecced or creaced. <br /> Tne rtsponsibi�au[horiry shali provide copies oi re priva�:or public data upon request by[�e individual subject of che daca. The responsible auchoriry <br /> may requir[he requudng person to pay the aca�.!coscs of malcing.cerrifying,and compiling the copies. <br /> The responsibiz au[horiry shall comp[y i.-imediacely, if possible, wich any request sade pursuant to�his subdivision,or within five days oi <br /> the da[e of�tte request,exciuding Sacucdays.Su:.:'ays and legsl holidays,if immediace compiiatce is noc possible. If he canaoc comply wich the requesc <br /> wichin rhac dme,he shall so inform[he individu�l,ar:d may have an addidooal five days wichin which to compiy wi[h the request,exe2uding Saturdays, <br /> Sundays and legsl holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest che accuracy or compleceness of public or pri�•ate ' <br /> dara conceming himself. To exercise chis righ[,�.�individual shall nodfy in wriang�he resporsble auchoriry describing rhe na�u:e of the disagreemeac. .. <br /> The responsibla aurhoriry shsll within 30 days ei�::: (a)correcc che data found to be inac�:rice or incomple�e and aaempt to nodfy pazt recipienu of <br /> inaccura:e or incomplece dac3, inctuding recipie:.a oamed by che individuai; or(b)aodfy ef:e individual chac he believes rhe daca to be correcc. Daea <br /> in dispuce shall be disc:osed only if ehe individn�'s state^ent of disagreement is ir:duded wi�h[he diseiosed dara. <br /> The dererminadon of ehe rasponsicl� auchoriry may be appealed pursuanc to che provisions of[he adminisrrarive procedure act reladng to <br /> con[ested cases. <br /> D:�T:� PRIVACY ADVISORY <br /> In accordance wich M.S. 13.04, S��bd.2, "RiQhes of subjects of data", �c•e would like to inform you that your request <br /> for a permit or license from che Ciry oi Orono or any of its departments may require you [o fumish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you fi:r�sh will be used to determine your qualification for che permit or license requested. <br /> ? You may refuse to supol;� daca, but refusal may require that the Ciry deny the permit or license. <br /> ;. The informa�ion may be shared wich ocher local, stace or federai agencies [o the excenc necessary to process <br /> the permit or license. <br /> d. If your requested permit or license requires Council action to approve, some informacion may become <br /> public. <br /> �. You have certa.in ri�� i:nder �1.5. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is requi:ed to process this applicacion or perm.it. <br /> , j�!/G �hj h�c � �sG//� � <br /> Finc �t�ddiz Lasc <br /> /4.1y� /�tSS�t.c�oc� �r <br /> ?�ddress <br /> �oG P r S �b✓L ✓! c S S"� 7•f 6/�-�-/�-8''�t vS�o <br /> Ciry Smce Zip PFonz <br /> I understand my ri�hts as staced zoove. <br /> � <br /> Signamre <br />