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i � <br /> Sec.13.0�i RIGI�iTS OF SUBJECTS OF DaT?, <br /> Subd. l. Tvpe of da[a. The righcs oi icdividual on whom[be dara is stored or m be s:�rcd shaII be as set focth in chis secrion. <br /> Subd.'_. Information reqirired to be�vea individual. a+n individual azked to suppiy private or confidendal dara concerning him.self�`-., <br /> be informed of: (a)[he purpose and in[eaded use of the requesud dam wishia che collecdn3 3ta�agency, polidcal subdivision,or sracewide ryst^: <br /> (b)whe:her he may refuse or is loga[ly requiied ro supply che requested data:(c)any known coasr.,"�'.e�c-aris:ng from his supplyiag or refusing ro sup�:,+ <br /> privare or conndenriai dara;and(d)the idenriry of oeher persoas or endries auchorized by ssare or fw��l law co re�eive che daca. "Ihis requiremea�s`,;`: <br /> noc appfy when an individual is as4:ed to sspply in��esri¢arive data,pursuanc to secdon 13.82, su�ivision 5, to a(aw enforceneac o�cer. <br /> The commissioner of re�enu riav pla� the nodr r�uired under this subdivision L� ttte individual income tax or prooem taz c=:t:-�? <br /> instrucaons insczxd of on those forms. <br /> Subd.3. ?,ccess to data br•individual. lipon request[o a responsible auchoriry,an i��ividual shall be informed whe�her he is che sub;c._ <br /> of s[nred dara on individuals,and whe:her it is cl�cs�ed as public, privace or confidendal. tipoa¢is furcher request,an individual who is the sub;_-: <br /> of stord privace or pubtic daa on individuals shall be shown[he dara wichout any charge ta hi*a a:.d,-if he desires,shall be iniormed of the cont�� <br /> az:d meaning of chat da[a. Aher an individual has been shown the privace dan and informed of i�Weaning, che dara need no�be disclosed to him.`�: <br /> six monrhs theraTur unless a dispu�e or acrion pursuanc to chis secdon is pending or addidoa�!da3 on che individual has beea coilecud or cra,-�. <br /> 'Ihe responsible au[horiry shall provida copies of dta priva�e or public data upon requesc by che in�:vidual subjcct of�he daci. T'ne responsible aucho.—:e+ <br /> may require [he requesring person to pay the acnial coscs of making.cerrifying,and compiling c_copies. <br /> The responsibla au[horiry shall comply immediate(y, if possible,wieh aay requesc maCe punuanc m this subdivision,or wi[hin five days o: <br /> the dacr.of the tequesc,ezcluding Samniays.Sundays and legsl holidays,iF immedia�c compliance is noc possible. ff he canno�comply wich[he reqLK. <br /> wichin�hac dsne,he shall so inform the individual,ind may have an addidonal five days wichin w�ch co compiy wi�k che request,exctuding Saturdays. <br /> 5undays and legat holidays. <br /> Subd.4. Procedure when data is not accurste or complete. An individual may cor.�s.the accuracy or compleaness of public or pm-z:e ' <br /> data conceming himsdf. To exercise�is righ[,an individual shall nodfy in wricing che responsic:=auchoriry describing che nacu:e of the disagree�e�� . <br /> The responsibla aurhoriry shall within 30 days ei�`.er: (a)corrccc[he dara found[o be inaccura�o:ir.comp:ew and aaemp�to noafy past recipicr.5 oi <br /> inaccurdce or incomplete data, including recipienc�named by �he individual; or(b)aodfy [he iL�:vidual thac he believes che dara to be correec D=� <br /> in dispuce shall be disc!osed only if the individual's sn[emenc of disagreemenc is ir.cluded wich�e disclosed dara. <br /> The decerminadon of tha responsible au�horiry may be appeaicd puauanc to [he provis:ons of e�:e admuus�arive procedure act rdaer.� � <br /> concesced cases. <br /> DAT�, PRIVACY ADVISORY <br /> In accordance wich�1.5. 13.04, Subd.2, "Ri�[s of subjecu of data", w�e w'ould like to inform you tha[your reeLes� <br /> for a permit or license from the Ciry of Orono or any of i[s departments ma.r require you to fumish certain privat� or <br /> confidencial information. <br /> You are notified that: <br /> 1. The information you furnish will be used to decermine your qu�ir:cation for the permit or license requesc��. <br /> ?. You may refuse to supply data, buc refusal may require that the City deny the permit or license. <br /> ;. The informacion may be shared with ocher local, sta[e or federal agencies to the ex�enc necessary to procas <br /> the permit or license. <br /> .�. If your requested permit or license requires Council action to aoprove, some informacion may becor:�-e <br /> public. <br /> �, You have certain riQhts under �1.5. 13.04 (available upon rec_:st) to review private data on yourse?=_ <br /> 6, Your full name is required to process this applica�ion or per�;:. <br /> � � -� �< < � <br /> o �� <br /> trsc �tiadlz <br /> �ddress <br /> C�ry Sace Zip Phona <br /> 0 <br /> � <br /> I underst y �, cs stated ' , <br /> ,� �', <br /> / / <br /> c�� � _ <br /> signacure <br />