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{ <br /> Sec.13.04 RIGFiTS OF SLBJECTS OF DaT�+, <br /> Subd. 1. Tvpe of data. The righcs or icdividual on whom[he data is stored or w be stoctd shall be u set for�in this sraon. <br /> Subd."_'. Informaaon reqtrired to be�ven individual. An individual asked to supply privare or confidendal daa concera�:.g himself shall <br /> be informed of: (a)[he purpose and inc:nded use of che requestcd dam wichin the collecdng's�ce agency,potidcal subdivisioa,or s�.:.wide ryst:m: <br /> �b)whether he may r.fuse or is le3ally required ro supply rhe requested data;(c)any Imown coasequeace arising from his Supply:�g or rius.ng to suppty <br /> privace or conndendai dara;and(d)�he idenrity of orher persoas or enades au[horiz:d by sra[-.or federal law to receive che da=. "Ihis �r:�uir_men[shall <br /> not apply when an ir.dividual is asked to supply iavesrigadve dam, pursuanc ro secdon 13.82, subdivision 5, co a law enioreWent occe:. <br /> 'ihe commissioner of r�enu nav pia- che nodc- re�uired under�his subdivision in the individual income as or pro�er.v mz refur.d <br /> instrucrions insce�d of on�hose forms. <br /> Subd. 3. ?.ccess to data by individuai. lipon request to a responsible auchority,aa individual shall be inform�whether he is the subjecc <br /> of scor_d data on individuals,and wherher it is clusifed as public, priva�e or confidenaal. ligon his fuczher request,an izdiv;dual who is the subjecc <br /> of scord privace or public dan on indi�•iduals shall be shown[he dact wichout any charge tn him and,'if he desires, shall te iniomed of rhe concenc <br /> ar.d meaning oi rhac dan. After an individual hu been shown�he privare daca and informed oi iu meaniag,the data need no�be disclosed co him for <br /> six monchs cheraiv.r unless a dispute or acrion pursuanc to ehis secrion is pending or addidooal dac3 on che individual has beea collrt:d or creared. <br /> Tne responsible auchoriry shall providz copies of che privace or public data upon requesc by che individual subjecc of�he da�a. T'ne resporsible auchoriry <br /> may requir �he requadng penon to pay the acn�l costs of making.cerrifying,and compiling[he copies. <br /> The cesponsible auchoriry shall compiy immediate(y, if possible, wirh any request madz pursuane co chis subdivis:on,or wis�in five days oi <br /> the dar^of ehe request,exciuding Sanirdays,Sundays and legal holidays,if immediace compliance is noc possible. If he canzoc comply wi[h che reques� <br /> wichin rha�time,he shall so inform rhe individual,and may have an addidonal five days wi�hin wtiich co comply with the re.;.:est,exdediag Saturdays, <br /> Sundays and legsl holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest�he accuracy or comp:�raess of pubtic or pri�•ate - <br /> data conceming himseif. To exercise t�is righc,an individual shall noafy in wridng[he respoasible aurhoriry describing che na^�re oi�e disagreemeac. .. <br /> The responsible authoriry shall within 3�days ei[l:er. (a)corrnct the dara found ro be inaccurate or incomplete and aaemnc w nodfy gast recipienrs of <br /> inaccurar or incomplece dara, including recipiena named by �he individual;or(6)aorify cl:e individual chac he believes th:dara to be correcc. Dara <br /> in dispu�e shall be disc:osed only if[he individual's sntemenc of disagreemen�is ir.cluded wich che disclosed dara. <br /> The dece:minaaon of the responsibte au�horiry may be appealed pursuanc to the provisions of the administrari�•e procedcr_act relaring to <br /> contes:ed c�ses. <br /> DATA PRIVACY ADVISORY <br /> In accordance wich M.S. 13.04, Subd.2, "Rights of subjeccs of data", we would like to inforn you that your requesc <br /> for a permic or license from che Ciry of Orono or any of its departments may require you to fumish certa_in private or <br /> confidencial information. <br /> You are nocified that: <br /> 1. The information you furnish will be used to de�ermine your qualification for the perm.i�or licerse requested. <br /> ?. You may refuse to supply daca, but refusal may require thac the City deny the perait or license. <br /> ;. The informa�ion may be shared wich ocher local, stace or federai agencies to the exten�necessary to process <br /> the permit or license. <br /> :}. If your requested permit or license requires Council action co approve, some informatioa may become <br /> public. <br /> j, You have certa'in riQhts under M.S. 13.04 (available upon request) to review priva�e data on yourself. <br /> 6. Your full name is required to process this applica[ion or permit. <br /> � ' �L f�.�I,PS <br /> First <br /> �fiddla Last <br /> aZ-1,S'� c� l� �_ - - <br /> �, / ' .��. �7s" - �aiy <br /> �,aa 55 / �/ V JJ�� l� — �� -�Y� / <br /> Ciry Snce Zip Pta�e <br /> I understand my righcs �s scaced above. <br /> Signacuro <br />