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� _ _;Y . „ + _ . � Scc.13.U;RIGHTS OF SLJBJECTS OF D?,Ta - , Subd. 1. Type oE data. The ri¢ha of individual on whom[he data is scoced or to be scor:d shaIl be as set fo�u4 in this secdon. • Subd.2. Information reqi3red to be givea individual. An individual uYed w supply private or confidenaal data eoncerning himself shall be informed of: (a)che purpose and inmadcd use of the requesc�daca wi[hia ehe collecang Sute agency,polidcal subdivisioa,or scatewide rystem; (b)whecher he may r:vse or is Icgally requird ro suppty the requesud dan;(c)any frnown coasequence arising from his supplying or refusing to supply privace or eontidenrial dara;and(d)[he idenriry of o[her persoas or cnad:s auchorized by snte or federal!aw to receive the data. Zhis requirement shali . no[appiy when an individual u asked to suppiy invesdeadve daca,pursuaac to secdon 13.83,subdivision 5.to a law enforcement oE�icer. • Zhe eomr,.issioner of revenue mav p(ace che noace rauir.d under rhis subdivision in the individual incone taz or orooem taz tefund ins�rucdons insuad of an chose forms. Subd.3. Acc�ss to data by tndiridual. Upon request to a responsible auchociry,aa individuai shall be informed whether he is the subject � of scocrd dac�on individuals,and whecher ic is ciusified as public,privac�or conFdenaal. Upon his furcher request,an individual who is the subjecc of s�ored privac�or pubiic dae on individuals shal!be shown che data wichout any charge to tiim and;if he des'ires,shall be informed of[he concent and meaniag of[hat dara. Afcer an individuat has been shown che privam daca and informed of iu meaning,[he data need not be d'uclosed to him for six monchs chereaccer uriless a dispuu or acdon pucsuan[to chis sccdon is pending oc addiaonal dara oa the individual hu been collecced or created. The r.sponsible auchoriry shall provide copies of the priva�e or pubtic data upon request by[he individual subjccc of[he dara. The responsible auchoriry may require che reques:ing person to pay the acaial cost�of making,cerrifying,and comp�ing the copies. The responsible au�horiry shall comply immedia�ely,if possible,wich any requcst made pursuant to this subdivision,or wichin five days oF the da�e of che requesc,exciuding Sacurdays,Sundays and legal holidays,if immediaca compliance is not possible. If he canaot comply with che cequesc wi[hin chat ame,he shatl so inform[he individual,and may have an addidonal five days wi�hin which to comply wich the request,excludiag Sacurdays, Sundays and legal holidays. Subd.4. Procedure vvhen data is not accurate or eomptete. M individual may coatest che accuracy or completeness of pubiic orpriti ate dara conceming tiir.ssetf. To ezercise�his ri¢h4 an individual shall noafy in wridng the responsibie auchoriry describing che nature of[he disagreemen� 'Ihc responsible authoriry shall wichin 30 days ei[her: (a)correcc the dara found to be inaccurate or incomplece and attempt W no¢fy past recipieacs of inaccurdte or incomptece dara, including recipients named by[ha individusl; or(b)noufy[he individual that he believes che data to be coaecc Data in dispute shall be disclosed only if the individual's scicement o!disagreement is included wirh th:disciosed daca. Tht de�erminadon of[he responsible auehoriry may be appealed puauant to che provisions of the administrndve procedure act relaang to contested eases. DATA PRIVACY ADVISORY . In accordance wich M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your request for a pernut or license from the Ciry of Orono or any of ics departments may require you to fumish certain private or confideatial information. You aze notified that:- 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with ocher local, state or federal a�encies to the extent necessary to process " the perm.it or license. 4. If your requested permit or license requires Council actibn to approve, some information may become public. 5. You have certain ri?hts 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 permic. � �i�� /� �I`�b;�l �� First �fiddle t '3�//s ��1 S�f L<�) �- f � S � Addreu a . <-:,�G �;' c� ��1 c,% iS�� c -� 3 - �Jl � Ciry Sace ZiQ Phone I understand my ri�hcs az stated above. . ��.= - �� s��« , � � ,/ .