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� � Sec.13.0-�RIGHTS OF SUBJECTS OF DaTa Subd. 1. Tppe of data. The rieh�s of individuai on whom c�e data is stor�or to be scored shall be as set forth in this secdoo. Subd.2. Information reqirired to be given individual. An icdividual as'�c3 co supPly privace or confid�ndal data concerning himself shall be informed of: (a)che purpose and in�ended use of the requesud dam wi�in the collecang'sta�ageacy,polidcal subdivision,or statewide sysum; (b)whe�her he may refuse oY is legaliy required�o supply che requested daa:(c)any l�own consequence arising from his supplying or refusing co supply privace or conndenrial data;and(d)the idendry of oeher peaoas or enaries a�chorized by state or fedecal law to rec�ive the data..'Ihis requiremen�shall noc apply when an individual is asked to supply invesoearive data, pursi:�^.t[o seccoa 13.82, subdivision 5, to a law enforcemenc officer. The commissioner of re�enue riav place the noace reauired �rd�r this subdivision in the individual ircome tax or propem tax refund instructions insczzd of on those forms. Subd.3. Access to data by indiridual. Upon request to a r.s�onsible aec:oriry,an individual shall be informed whecher he is the subject of scored data on individuals,and whe�her it is classified as public,privac�or conf�d�r.rial. Upon his furthe�request, an individual who is the subjecc of scored priva�e or public data on individuals shall be shown ehe data wiu.ou[any c:.3rge to him and,-if he dasires, shall be informed of che concenc and meaning of chac dara. After an individual has been shown the priva�Ca�and i�:ormed of ics meaning,the daca need not be disclosed to him for six months thereafter unless a dispute or acrion pursuanc to this secdon is�ending or addidonal data on the individual has been collec�ed or creaced. The responsible auchoriry shall provide copies of the private or public data a�on reqacs:by the individual subject of che data. The responsibte au�horiry may requir� che requesdng person to pay the ac�ual coses of makinc,ce=.�:ing, and compiling the copies. The responsible authoriry shall comply immediacely,if possib!=,wi�h any r=quest made pursuant to this subdivision, or within five days of ehe date of rhe request,excluding Sacurdays,Sundays and legal holidays,i;ir,.media�e compliance is noc possibie. If he cannot comply with the reques� within thac rime,he shall so inform the individual,and may have an ad�i�c:al Five da}•s wichin which to comply wich the request,exciuding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. ?.n individual may concest the accuracy or completeness of public or pri�•ate data concerning himself. To exercise�his rieht,an individual shall nodr+ia wricin;c=responsible authoriry describing�he nanire of the disagreement. The responsibte authoriry shall wichin 30 days eicher: (a)correct rhe dae icund to be inaccurate or incomple�e and attempc to noafy past recipienes of inaccurate or incomplete data, including recipiencs named by the indiviC�_�;or(b) r.oafy the individual that he be:ieves the data to be coaect. Data in dispuce shall be disclosed only if the individual's statement of disagr��_nt is i^.c:�ded with the disclosed dara. Ttie decerminadon of the responsible au�horiry may be appe�:ed pursuanc co the provisions of the adzinistrarive procedure acc relaang to contesced cases. DATA PRIV�CY AD�ZSORY In accordance with M.S. 13.04, Subd.2, "Riohts of subjects oi da�a", we would like to inform you that your reouest for a permic or license from the Ciry of Orono or any oi is depar�mencs may require you to furnish certain private or confidential information. You are notified that: 1, 'I�e 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 City deny the permit or license. 3, The information may be shared wich other local, stace or federal agencies co the ex�ent necessary to process the pernut or license. 4. If your requested permit or license requires Council action to approve, some information may become . public. j, You have certain ri�hts under M.S. 13.04 (available upon reques[) to review private data on yourself. 6, Your full name is required to process this applica�ion or permi[. �a��S �� C�-�� �fiddle Last Firsc ' 1/o�oS .��'�� -� Address �S�z� c��1• S�j�� �lf��vD ��i�/ �'J'�� — Ciry State Zip Phone I unde tand my ri�hts as state above.� . � �i� �� � � �,-�� ,�/I�Cr si�tia re / / �