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Sea13.0-1 RIGHTS OF SUBJECTS OF DaTa Subd. 1. Type of data. "Ihe righ�s oF individual on whom ti:data is s�:�or co be stored shall be�s sec focth in this secdon. Subd.2. Informatioa reqirired to he given individual. r�n icdi�•idual as's�co supply private or confideadal data coacerning himself sball be informed of: (a)[he purpose and in[ended use of the requestcd dara wi�in the collecang'stace agency,polirical subdivision,or statewide sysum; (b)whecher he may refuse oY is legally r�quired to supply[he requested dzca;(c)any�ov+n eoasequeace arising fmm his supplying or rcfusing to supply pri-+a�e or conndenaal da�a;and(d)the idendry of other persoas or enad:s a�chorized by seate or federal law to rceive the data..'Ihis requiremeac s6a11 no[apply whan an ir:dividuai is asked to supply invesdgadve daca,purn:_c to seceoa 13.82,subdivision 5,to a law enforcemeat o�cer. The commissioner of r^��enue r-iav place the norice rauited e^d-r this subdivision in the individual ir.come tax or propem_t;x reFur.d instruc�ions instead of on those forms. Subd. 3. Access to data b�indi�-idual. Upon reques�to a r.r,.oasible ae�.oriry,an individual shall be informed whether he is[he subjecc oF scored data on ir.dividuals,and whe�her ic is class�ed as public,priva�or confid�r.rial. Upon his funher request,an individual who is the subjeu of srored privare or public data on individuals shall be shown the data w•i�out any e:.3rge to him and,-if he dzsires, sball be informed of�he conc�n� and meaning of�hac da�a. After an individua!h�s been shown the priva��aa and iL.'or�ned of i�s meaning,the data need not be disciosed to him for six mon�hs ehereaicer unless a dispure or acaon pursuanc to this secdon is ve;�ding o;addiaooal data on 4'�e individual 6as been collecc�d or creac�d. The responsib(e aurhoriry shall provide copies of the priva[e or public dac�L�on requ:s:by the individu�l subjecc oF rhe da�a. The responsible authoriry may require [he requesring person to pay the accual coscs of making,cer.::;ing, ar:d eompiling the copies. 'Ihe responsible auchoriry shall comply immediately, if possib!=,wich any r_quesc made punuant to chis subdivision, or wichin five days of th=da[e of the request,ezciuding Saturdays,Sundays and legal holidays,i;ir..mediace compliance is not possible. If he cannot comply wich the request wichin�hac dme,h�shall so inform che individual,and may have an addi�e;.al five days wichin which to comply wirh the request,exciuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. ?.n individuzl may contest the accuracy or completeness of public or pri�•ate daca concerning himself. To exercise chis riehc,an individual shall noafy ia w•ridng�=rsponsible authoriry dzscribiag che nacure of the disa;reemeac. The responsibte auchoriry shall wichin 30 days either: (a)correcc the da�icund to be inaccurate or incomplece and aaempt to norify pasc recipien�s of inaccun�e or incomplete data, inciuding recipients named by che individ��t;or(b) coefy the individual 44at he believes the data to be corcect. Dac3 in dispuce shsll be disclosed only if rhe individual's stacemeac of disagre��=nc is i:c:�ded with che disclosed dara. 'I1ie decerminarion of the responsible au[horiry may be appea�=�'pursuaz:to the provisions of the administrarive procedure act relaring to contesced cases. DATA PRIV�CY AD�ZSORY In accordance with M.S. 13.04, Subd.2, "Ri�.hts of subjects oi data", we would like to inform you that your request for a permit or license from the Ciry of Orono or any oi is d�par:.�.ents may require you to furnish certain priva�e or confidential information. You are notified that: 1, The informa[ion you furnish will be used to de:emune�'our qualification for the perm.it or license requested. ?. You may refuse to supply data, but refusal r�ay require that the Ciry deny the permit or license. 3, The information may be shared wich ocher loczl, state or federal a�eacies to the excent necessary to process the permit or license. 4. If your requested permit or license requires Council ac�ion to approve, some information may become . public. �, You have certain ri�hts under M.S. 13.0=1 (zvailable upon request) to review private data on yourself. 6, Your full name is required to process this 2pplication or perm.it. / � L �� l �i .�.-t �� First ;�tiddle Las� � C U�t f��o ��r K�-.�. S Address � 7�G�Tvit�.� —,i�-�� -� ��`-{ZU ��Z ��'�� Z�`-� — Ciry � Srace Zip Phone I understand my ri�hts as scated above. / %�r/'d'r^ � � 1 �i�.� / SI�Ra[tiCC