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Sec.13.0-L RIGHTS OF SUBJECTS OF D�T�1 Subd. 1. Tvpe of data. "Ihe ri¢hcs of individual on whom[he da�is s�:�or co be stored shall be as set forth in this secaon. Subd.2. Information reqirired to be given individual. An iLdi�•:dual ask�co supplY priva�e or confidenrial data conceming himself shall be informed of: (a) che purpose and in�ended use of the requesud dara wi�in[he coII��ang�tate ageacy, polidcal subdivision,or srarewide rysum; (b)whecher he may refuse oY is legally required to supply che requesced dan:(c)a�1y I�o��consequeace arising from his supplying or refusing to supply privace or conndenrial data;and(d)[he idendry of other persoas or endri:s ze•Wer,z:.d by s-te or federal law to receive the data..This requirement shal] not apply when an individual is asked to supply invesrieaave daea,pursu=^.c ro s:ccoa 13.82, subdivision 5, co a law enforcement officer. The commissioner of r�venue r-iav place the noece reauired � d•r tt+is su'rdivision in the individual income tax or propem rax refund inscructions inscead of on chose forms. Subd. 3. Aecess to data b�indiridual. Upon request to a r.s�oasib!e aecyor.ry,an individual shall be informed whether he is the subject of s�ored data on individuals, and whe�her it is ciassified as public,priva�or confid:c:.1. Upon his further request, an individual who is the subject of srored privace or public data on individuais shail be shown the data w�i�ouc a:y c':v�-3e to hun and,-if he desires, shall be informed of the content and meaning of�hac data. After an individua!has been shown the priva��a3 ar.d i::,;r-'=d of its meaning,che dara need not be disclosed to him for six mon�hs �hereafter unless a dispute or acrion pursuanc to [his secrion is�e:.diag o:azdirional data on the individual has been collected or creaced. The responsible auchoriry shall provide copies of the privace or public daea L:on roqs:s:by r.he individual subjecc of[he dara. The responsible au[horiry may require[he requesring per5on to pay the actual cos�s of making,ce^.�:ir.g,a:.d co�piling the copies. The responsible authoriry shall comply immediacely,if possible,��i�a aay r=.;_est made punuant to this subdivision,or wichin five days of the date of[he requesc,excluding Sacurdays,Sundays and(egal holidays,ii ir..rcd��=compliance is noc possible. If he cannot comply with the request wichin thac dme,he shall so inform the individual,and may have an addi�er.a!five days wz�in which to comply wich che request,exetuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. �n icd•,viduzl nay contest the accuracy or completeness of public or pri�•ate data conceming himself. To exercise this rieht,an individuai shall noafy ia•�::::g c=:=s?onsible authoriry describing che nacure of the disagreemeat. The responsible authoriry shall within 30 days either. (a)corr.cc the da�tcar.d ro be i*Lc.urate or incomplete and aaempc to nodfy past recipiencs of inaccurace or incomplece data, including recipien[s named by the individLJ;or(b) r.oaf}• the individua!that he believes the data to be correcc. Data in dispu�e shall be disclosed only if the individual's statement of disagre.�_r.:s irc:_�r' with the disclosed data. Ttie de�erminarion of the responsibte authoriry may be appea�:�ru:�suz;.�to c`:e provisions of the adminisaarive procedure act relaang to conrested cases. DAT� PRIVaCY �D�ZSORY In accordance with M.S. 13.04, Subd.2, "Ri�ts of sub;ect� o:da.z', we would like to inform you tha[your reQuest for a permit or license from the City of Orono or any oi ia d�pz�u.e�Ls may require you to furnish certain priva�e or confiden[ial information. You are notified that: 1, The information you furnish will be used to de:er�ine��ou;qualification for the permit or license requested. 2. You may refuse to supply data, but refusal �ay rzquire that the Ciry deny the permit or license. 3. The information may be shared wi[h other locz, stace or federal agencies to the extent necessary to process the pernut or license. 4. If your requested permit or license requires Council action to approve, some information may become . public. �. You have cer[ain righ�s under M.S. 13.04 (a•:�:lable epon request) to review private data on yourself. 6. Your full name is required to process this application o: perm.i�. ,�- I.�,v�u� �,� �-�z ��"�. Firsc �tid � Lasc 3� �' � � b Address "�. / "\J " J,� � � � I �� y /I d�� \nl a. Z '�, Ciry Sar.: Zip Phone I understand my ri�hts as stated above. �� . �� Signacure