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� Sea 13.04 RIGHTS OF SUB.TECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is siored or to be siored shall be as set forth in tfus secdon. Subd.2. Information required to be given individual. An individual asked to supply private or confidenaal data conceming himself shall be informed of: (a) the purpose and intended use of the requested data within the collecan,'srace agency,political subdivision,or statewide system; (b)whether he may refuse or is legally required to suppty the requested data;(c)any lazown consequence arising fmm his supplying or refusing to supply private or co�dendal data;and(d)the identity of other persons or enddes authotized by srate or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav piace the norice required under this subdivision in the individual income tax or propertv rax refund inscructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether i[is classified as public,private or co�denaai. lipon his further request,an individual who is the subjecc of stored private or public dara on individuals shall be shown the data without any charge to him and, if he desires, shall be infoaned of the coocent and meaning of that data. Afrer an individual has been shown the private data aud informed of iu meaning, the data need not be disclosed to him for six months thereafter unless a dispute or action purs�.uit to this secrion is pending or addirional data on the individual has been collected ar created. The responsible authoriry shal!provide copies of the private or public data upon request by[he individual subject of the data. The responsible authority may require the requesrin�person to pay the acnial cosu of making, certifying, and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision, or within five days of the date of the request,excludin�Saturdays,Sundays and lega!holidays,if immediate compliance is not possible. If he cannot comp(y with the requesc within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest[he accu�acy or completeness of public or private data conceming himself. To exercise chis right,an individual shall noofy in writing the responsible au�horiry describing the nacure of thz disagreemeac. The responsible authoriry shall wichin 30 days either: (a)correct the dara found to be inaccurace or incomp!ete and attemp[to notify pasc recipienu of inaccurate or incomplete data, including recipients named by the individual; or(b) notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included wirh the disclosed data. The determination of rhe responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating co contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we cvould Iike.io inform you that your request for a permit or license from the City of Orono or any of i[s departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you fumish will be used to deternune 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 other local, state or federal a�encies to the extent necessary to process the permit or license. 4. . If your requested pemut or license requires Council action to approve, some information may become public. ` 5. You have certain ribhts undzr M.S. 13.04 �available':upon req��est);to review pri�ate data on yourself. 6. Your full nam;, is rzquired to proccss this agplication or pzrmit.;:.. , , S�r�„� �; L�c�-T Fi:st Ivliddie • La`� �ctr�4 4 s ,�, z 75 M,ar �c�r Sl�: . . -- Address ` � ` _L�r�r,�t F-1�-�o�.�� h°�N � SS��S G/2 - �3�- �i�Z.C� City State .._ ._ Z�p Phone I understand my rights as stated above. � �� G��- �� --J z�- �3 Si�nature '