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, , Sec.13.03 RIGHTS OF SLBJECTS OF D:�T� Subd. 1. Type of data. The ri2h�s of individual on whom t�e data is sto�3 or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual ask�3 to supply private or confidendal data conceming himself shall be informed of: (a) the purpose and in[ended use of the requesred daca wi�in the coll�ccing'sta�agency,poliacal subdivision,or sncewide sysum; (b)whe�her he may refuse oT is legally required co supply the tequested data;(c)any 1�ovrn coasequence arising from his supplying or refusing to supply priva�e or conndendal data;and(d)the idenrity of o�her peaoas or enddes zathorized by scate or fedecal law ro r�ceive the data..This requ'uemenc shall not apply whzn an individuai is asked to supply invesrigadve dara,pursus^.c to seccoa 13.82, subdivision 5, to a law enforcemenc ofricer. The commissioner of revenue r�av place che norice reauired erd�r this subdivision in the individual income tax or prooem tax refund instructions inscead of on those forms. Subd.3. ?.ccess to data by indi�idual. Upon request to a res�onsible auc:^.ority,an individual shall be informed whether he is the subjecc of s�ored data on individuals, and whe�her it is classified as public,privac:or confid=nrial. Upon tils further request, aa individual who is the subjecc of s�ored private or public data on individuals shail be shown[he data wiu out any ci�r3e to him and,-if he desires, shall be informed of[he concent and meaning of rhac data. Aftzr an individual has been shown ehe priva��ac�and ic:ormed of ics meaning,che dara need not be disclosed to him for six mon�hs chereafter unless a dispute or acrion pursuanc co this secdon is�:nding or addiaonal data on the individual has been cotlecced or creaced. The responsible authoriry shall provide copies of the priva�e or public da�n�on reques:by the individual subject of�he data. The responsible auchoriry may require che requesdng per5on to pay the accual cos�s of makine,cer;;ing,and compIling the copies. The responsible authoriry shall comply immedia�zly,if possibl=,with any r=quest made punuant to this subdivision,or wichin five days of the dat�of the requesc,excluding Saturdays,Sundays and legal holidays,ii ir..media�e compliance is noc possible. If he cannot comply with the request wiehin thac ame,he shall so inform the individual,and may have an addico;:al five days within which to comply wich the request,exeiuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate data concerning himself. To exercise chis rieht,an individual shall noafy ia wridng�:=responsible authoriry describing�he nanire of che disagreemenc. The responsible auchoriry shall within 30 days either: (a)correct the dae tcund to be inaccurate or incomplece and attempt to nodfy pasc recipienes of inaccura�e or incomplete data, including recipients named by [he individL�;or(b) r_orify the individual tha[he believes the data to be correcc. Data in dispu�e shall be disclosed only if the individual's statement of disagr::�=nt is i^.c:sded with the disclosed dara. Ttie de�ecminarion of the rosponsible authoriry may bz appza:e�pursuane to the provisions of che admuuscrarive proeedare aet reladng to conresced cases. DATA PRIV�CY AD�ZSORY In accordance wich M.S. 13.04, Subd.2, "RiQh[s of subjects ot data", we would like to inform you that your reauest for a permit or license from the City of Orono or any of ia deparments may require you to furnish cenain private or confiden[ial information. You are notified that: 1, 'Ihe 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 tha[ the Ciry deny the permit or license. 3, The information may be shared with o�her loc�l, state or federal agencies to the excent necessary to process the permit or license. 4. If your requested perm.i[ or license requires Council action to approve, some information may become . public. �. You have certain rights under M.S. 13.04 (2vailable upon request) to review private data on yourself. 6, Your full name is required to process this zoplicacion or permi�. )i� `' ��JY L�- �� First Viiddle Last �6�I�'7� ��,�✓�q��,-L �'�� - Address 11 //� , y� j.�� ) � �1f l�%1`/'�.� � ��/f'h l /G"9{�^y� ��/�✓� ��. Ci�, Sta[e Zip Phone I unders d my ri�hts - tated above. Signamre --