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Sec.13.04 RIGHTS OF SL'BJECTS OF DaT,� Subd. 1. Type of data. The rieh�s of individua!on whom the data is scor�or to be scored shall be as set for[h in this secdon. Subd.3. Information reqirired to be given individual. An individual aske3 to supply private or confidendal data concecning himself shall be informed of: (a)the purpose and in�ended use of the requesred dara wi�in the collecting'state agency,poliacal subdivision,or statewide rystem; (b)whecher he may refuse or is legaily required co supply[he requesced daa:(c)any I�own consequence arising from his supplying or refusing to supply priva�e or conndential data;and(d)the idenrity of o[her persons or enriaes aLchorized by state or federal law to receive the data. 'Ihis requiremenc s6a11 noc appty whzn an individual is asked to supply investieadve dan, pursu�^c co sectioa 13.82, subdivision 5, ro a law enforcemenc officer. The commissioner of re�enue r�av place the norice reauired e d�r this subdivision in the individual income tax or propem tax refund instructions insczad of on those forms. Subd. 3. ?.ccess to data by indi�idual. Upon request to a rscoasible aec�oriry,an individual shall be informed whether he is the subject of scored data on individuals, and whe[her it is classified as public,priva4 or confid�r.aal. Upon his further requesc, an individual who is the subject of scor�d private or public data on individuals shall be shown[he dara wi:;.ouc any ciiarge to hun and,-if he desires, shall be informed of the concent and meaning of[hat data. After an individual has been shown the priva��ac�and i�:ormed of ics meaning,che data need not be disclosed to him for six mon�hs ehereafter unless a dispute or acrion pursuanc to this secrion is�ending or addidonal data on the individual has been collected or created. The responsible auchoriry shall provide copies of the private or public data a�on reques:by the individual subject of the data. The responsible authoriry may require[he requescing person to pay the actual cosu of makine,cer�:ing, and compiling the copies. The responsible authoriry shal(comply immediately, if possib!e. wich any r_quest made punuant to this subdivision,or within five days of the date of the reques�,exciuding Saturdays,Sundays and legal holidays,it immediate compliance is noc pos5ible. If he cannot comply with the request wi�hin thac dme,he shall so inform che individual,and may have an addiaor.al five days within which to comply wirh the request,exciuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compleceness of public or pri��ate data concerning himseif. To exercise this rieht,an individual shall norify iZ wridng 4::responsible authoriry describing�he na[ure of the disagreement. The responsible au�horiry shall within 30 days either: (a)correct[he dae tcund to be inaccucate or incomplece and attempc to nodfy past recipienes of inaccucate or incomplete data, including recipients named by che individL�I; or(b) r_orify the individual thac he believes the data to be correct. Data in dispuce shall be disclosed only if the individual's stacement of disagre��enc is L.c:nded with the disclosed data. The de�erminarion of the rtsponsible authoriry may be appea�:�pursuan:to the provisions of che administrarive procedure act reladng to concested cases. DAT� PRIV�CY AD�ZSORY In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your reauest for a permit or license from the City of Orono or any of irs deparments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to de:ermine ��our qualification for the permit or license requested. 2. You may refuse to supply data, but refusal nay require that the Ciry deny the pemut or license. 3, The information may be shared with o[her loc�l, state or federal a�encies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. �. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or perm.ic. � . N� , First ,�+�, ; �fiddle Lasc ��l�� (J�1 l P��W1� �-w-, Addres � �r �'V �� CJ �I � � �� l � ��" Ciry � State Zip Phone I under and my rights as stated above. Sign