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r - <br /> Sec.13.0�1 RIGHTS OF SLBJECTS OF DAT:� <br /> Subd. 1. Type of da[a. 'I�e righa ot iadividual on whom[he data is sto:`d or oo be siored shall be as set for�h in chis secrion. <br /> Subd.?. Information reqirired to be�vea indiridual. ,�n individual ask:d to suFriy privare or confidenrial dara concerning himself shall <br /> be informed of: (a)[he purpose and inc:.nded use of[he cequesud dan wichin�he cotIecdn3"sa_agency,polidcal subdivision,or sracewide rystem: <br /> �b)whecher he may rtfuse or is Iegally tequited co supply[he requested dara:(c)any I�own cons-:-eace arising hvm his supptyi:,g or refusing to supply <br /> priva�e or conndenriai data;and(d)the idendry of ocher persoas or endaes auchoriz:d by szam or federal law to�eu1VC[I1G d3C1_ �115 iGqllllCIIiCd[5�13II <br /> noc apply when an individual is asked ro supply iacesri¢adve dan, pursuanc ro secaon 13.82, si:bdivision 5, to a law eniorceazn[officer. <br /> The commissioner of re�e�u nav ola- che nodc- r��uir^d under this svbdivision in the individual income tax or prooem taz refur.d <br /> instrucaons inscead of on�hose forms. <br /> Subd. 3. access to data br•individuaI. liport requesc to a responsible au�':oriry,�a individual shall be informed�vhether he is the subjecc <br /> of stor_d data on individuais,and whe:her it is clusified as public, private or cocu:de::rial. tiFoa his further request,an individual who is the subjecc <br /> of stord privace or public data on individuals shall be shown�he da[a wiehout any c:3r3e to h�and,-if he desires,shali be incormed of[he concenc <br /> and m:aning oi chat dara. Aher an individual h�s been shown the privatt data and inforned oi its meaaiag,[he dara need not be disclosed m him for <br /> six mon�hs thereaiter uniess a dispute or acrion pu;suanc to ehis secdon is pending or addidoeal data on the individual has been collect�d ar crea�d. <br /> The responsibl�au�horiry shall provida copies oi che privace or public daca upon requ:s:by�he ir�'ividual subject of�he dan. The responsible auchoriry <br /> may require the requesting person ro pay the acwal coscs of making,cerafying,ar.d:ompiliag �he copies. <br /> The responsibia auchoriry shall compty immediatety, if possible, wich acy:rquest�L�pursuant to[his subdivision,or wichin five days oi <br /> the daw of rhe requesc,ezciuding Saeurdays,Sundays and legal holidays,if immedu:e compliatce is not possible. If he cannoc comply with[he requesc <br /> wichin rha[dme,he shall so inform[he individual,and may have an addidooal five days wishia which to comply wi[h the requesc,exciuding Sacurdays. <br /> Sundays and legsl holidays. <br /> Subd.4. Procedure whea data is nat accurate or complete. An indiviC:al may con�st che accurdcy or comp(ateness of public or pri�•ate ' <br /> data conceming himself. To exercise chis righ[,an individual shall noafy in wricing�`:e r-sPoes��i=auchoriry describing�he nacu:e of the disagteemeac. .. <br /> The responsiblz au�horiry shall wi�hin 30 days ei�`.er. (a)correcc che dara found ro t�inaccu�=or incomplete and aaempe to nodfy past recipients of <br /> inaccurace or incomplete daea, including recipien�named by �he individual: or(b)cecify d:a iLdividua!thac he believes[he dara to be correcc. Data <br /> in dispuce shall be disc'.osed only if the individual's sra�emenc of disagreemenc is ir.cluded wica[he disclosed dara. <br /> The determinadon of tha responsible auchoriry may be appealed pursu�:.c:o the pro�isions of tha admuustrarive procedure act reladng to <br /> concesced cases. <br /> DAT�, PRIVACY AD`ZSOR�' <br /> In accordance wich M.S. 13.04, Subd.2, "Righcs of subjecu oi data", �.�e wouid like to inform you tha[your request <br /> for a permit or license from the Ciry of Orono or any of its dep�-:.�.ents �y require you to fumish certain private or <br /> confiden�ial information. <br /> You are notified thar. <br /> 1. The information you furnisa will be used to determine your qua'.i;ication for the permit or license requested. <br /> ?. You may refuse to supply daca, but refusal may reau:re that the Ciry deny the perm.ic or license. <br /> ;. The informacion may be shared with ocher local, scac�or feden.l a;encies to the extent necessary to process <br /> the permit or license. <br /> :}. If your requested perm.i� or license requires Council action to approve, some informacion may become <br /> public. <br /> �, You have cenain riQhcs under M.S. 13.04 (availabl� uoon request) to review private data on yourself. <br /> E, Your full name is required to process this applica�ion or pe.u:it. <br /> � � <br /> o��� f-�✓,�1 r�Sev� <br /> Fint � vfiddle Last <br /> �`t� SG„o. Q��� k/2 <br /> �ddcess $S j� - � � y`7`� <br /> a ' <br /> � <br /> ciry sace zip Proae <br /> I understand my rights �s stated above. <br /> '� <br /> Si�'naniro <br />