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. - �- - Sec.13.QS RIGHTS OF SUSTECTS OF DATA • Subd. 1. Tppe ot data. Zhe righrs of individual on wham the dara is stomd or ro be stor.d shall be u sec torch in chis sectioa Subd.2. InlormaCon reqirirrd to be givm indiridual. �n iadividuaI asY:d to supply privare or eonFdenaal da�eoacerning hir.sself shaIl be im`orB::d o,`: (a)[he purpose and imm�ded use of che cequesced daa wichin the eoIIecang�are agenty�poliacaI subdivision,ar smmwide rysc:m- (b)whe�`.e:ho r...ay r_.r�us:or is.legally requir:d to suPPtY.eSe r.quesLd dan;(c)a:y Y.�own eoas:queece arisiag from his suppTyiag or refusiag to suppty privace or co:i::d:r.�aI da�;ar:d(d)t�e idenriry of ocherpecsoas orec3d:s au•�or�e3 by sGm orfeae�'��a;�receive che daa. This r.quirc�eac s�a11 not a2FIy wcen an ir.dividuaI is ask:d[o supply invesdgadve daa,pursuanc co secdoa 13.82,subdivision 5,�a[aw enfarcementofncer. . • "Cie cenmiszione�of revenue mav olac; �he nodc- rauird und-r this su�division in the individual ircome ez or orooem tax refund instrucdons L�suad oEon�hose iomu. . Subd.3. Access to data by indiridual. Upon tequesc ta a tespansible auchociry,an individual shall be informed whe�her he is the subjecc ef sser.d daa on individuaIs,and whechec i�is ctass4fied u pubiic,private oc eonF.dena�i. Upon his furcher r_quest,aa icdividaal who is[he nsbjecc of stor:d priva:e ar public data on iadividuals shall be shown ehe daa wichaut any charge to him arsd;if he desiru,shalI be infocmed of the content ar.d meaniag of chat daa. Aher an individuai hit been shown t6e privac:daa ar.d intormed of ia meaaing,the daa ne:d noc be d'uclosed bo him for six monc�s�her_afur unl:ss a dispuce oc acaon pucruanc eo this secaon is pending or addidoaal dara on the individuaI has been collecc:d or ereamd. The tespoc�tib(e auchariry shaIl'provida eopies of�he privan or pubiic daca upon ccqu:st by the individual subject oC che data. Tha respoasible auchoriry may requin che r.quadng person to pay ehe aceual cosu ac ma.icing,eecdfying,aad eomp�ing the eapia. The responsibte auchoriry sha11 eamply imn;ediataty,if possibie,wich aay requat made pursuant w this subdivision,or wichin five days of the da�:of che reqaes�ezc[uding Sacurdays,Sundays and legal holidays,if immedi�te compliaace is notpossible. If he eanaot eompty with the request wichin that dme,he shall so inform the individual,and may have an addidoaal fiv:days within which to compiy wich the request,ezcluding Saiurdays, Sundays and 1e3a1 holidays. . . Subd.4. Procedure whea data Ls not accurato or eomplete. An icdividual may eonc:st die accurecy o�compteteaess ofpubtic orprivace dara concerning hirnsetf. To ezercise�his cight,an individual shaIl aodfy in wridng dte respoasibie auchociry desen'bing the aanire of ehe disagreemeac Zhe respoasible au�horiry shall within 30 days ei�:cr: (a)correct�ha dzra found to be inaccurac�or incomplao aad aaempc to nodfy pasc tecipien�s af inaccura�e or incomptece data,including recipien�s named by the individua.l;or(b)noafy the iadividual thac he believes the data to be cocrecc. Daa in dispuce shall be disclosed only if the individuaI's sca�cment of disagreem:nc is included wich tfie disclosed data. The dtcerminadon of the rtsponsible au�horiry may be appaaIed purnsanc to the provisions of tha adminisa�rive procedure act relatiag to eont�sud cases. . � DATA PRTVACY ADYISORY � In accordance wich M.S. 13.04, Subd.2, "Ri�hcs of subjecu of data",we wouId like to inform you that your request for a peraut or Iicense from the City of Orono or any of its departments may require you to furnish certain private or confiden[ial information. You aze notified that: 1. The information you furnish will be used to detemune your qualification for the permit orlicense requested. 2. You may refuse to supply data, but refusal may require that the Ciry deny the permit or license. � 3. The information may be shared with o[her local,stace or federal a�encies to the ettent necessary to process the permit or license. � 4. If your requested permit or license requires Council action to approve, some information may become . public, . . . . . . � . . �5. You have certain ri�hts under M.S. 13.04�(availabte upon request) to review private data on.yourself. . . 6. Your full name is required to process this application or permit. �/--� � �_ /� � !`"��/--� I S c' 'L, Fust � • �fiddle I.asc • � ,�:-� �� (,� -- �� L. %z" Lc/ /�_- Addreu — ,, ' ✓/ _ ._-��-; �! I � -- �'� 7� L r/.� �2 ��---�-.? // �v ) � f r �«Y Sate Zip Ptiane I understand my '�ts as s, above. ,y� � �J ',. --�__ � �� %> Signacura / .