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� Sea13.0-1 RIGFiTS OF StJB.TECTS OF D�Ta ' Subd. 1. Type of data. 'Ihe righcs of individual on whom the data is sto:�or to be stored shall be as set focth in this secaon. Subd.2. Information reqtrired to be given indi��dual. An ir.di�idual asY�to supply priva[e or confidendal dara conceming himself shall be informed of: (a)the purpose and iacended use of the requuud data v.i�in the colleccing�tate agency.polidcal subdivision,or sratewide rys[em; (b)whe�her he may refuse oY is legatly required co supply ehe r.quested dan:(c)any l�o�vn coasequeace arising from his supplying or refusing to supply privace or conndenriai data;and(d)the idendry of oeher penoas or endda acchoriz-d by scate or federal law to receive the data..This requiremenc shall no�apply when an individual is asked to supply invesdgadve daea,pursur::co secaoa 13.82,subdivision 5,co a.taw enfarcement o�cer. The commissioner of revenua mav place the noace rewired crd-r this subdivision in the individual income tax or oroaertv tax refund instructions inscead of on chose forms. Subd.3. Access to data by indi�idual. Upon request to a r.roosible aechoriry,an individual shall be informed whether he is the subject of scored data on individuats,and whecher ic is classified as public,privar�or con@der.rial. Upon his further requesc,an iadividual who is the subjecc of scora�i private ar pubtic dara on individuals shall be shown the dara wi^auc any c'narge to him and;if he desires,shall be informed of the concent and meaning of chac data. Aftar an individual has been shown ehe priva��aca and i�:ormed of i�s meaning,the data need not be disetosed ro him for six mon�hs choreafcer unless a dispute or acaon pursuanc co chis secdon is�ending or addidonal data on[he individuai has been cotiected or creaced. The responsibla auchoriry shali provide copies of the privace or public data econ reques:by che individual subject of the daea. The responsible auchoriry may require che requesring person to pay the accual cosu of makin¢,ce._:;ing,and compiling the copies. 'Ihe responsible au�horiry shall comply immedia�aly,if possib!_.wi�h any r_quest made pursuant to this subdivision,or wichin five days of the data of the reques�,excluding Saturdays,Sundays and legal holidays,ii irnmcdizt.^.compliance is not possible. If he cannot comply with the request within thac rime,he shall so inform che individual,and may have an addi�ec�l five davs wirhin which to comply wich[he request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. �n indivizual may contest rhe accuracy or compteceness of public or private daca conceming tiunself. To exercise[his righc,an individual shail nodfy ia wridng c:e responsibte authoriry describing che nacure of the disagreemeat. The responsible auchoriry shall within 30 days either: (a)corrct che dat�fcund to be inaccurat�or incomplete and attempt to nodfy past recipiene�of inaccucace oc incomptete dara, including recipients named by che individi:a[:or(b) �odfy[he individual that he balieves the data to be cocrece. Da�a in dispu�e shall be disclosed only if ehe individuai's stacecr.enc of disagrea�=nc is�.c:ided with che disclosed data. The de�erminadon of the responsibte auchoriry may ba appea:ed pursuacc to �he provisions of cha administrarive procedure act reladng to contesced cases. . � � DATA PRIV:�CY AD�ZSORY In accordance with M.S. 13.04,Subd.2, "Rights of subjects oi data',we would like to inform you tha[your reauest for a permit or license from the Ciry of Orono or any of ia depar�ents may require you to furnish cercain priva�e or confidential information. You are no[ified that: 1, The informa[ion you fumish will be used to de;ermine�•our qualification for the permit or license requested. 2. You may refuse to supply daca, buc refusal nay require that the Ciry deny the permit or license. 3, The informacioa may be shazed with ocher loc�l, stace or federal agencies to the excent necessary to process the permit ar license. 4. If your requested permit or license requires Council action to approve, some information may become . . public.. �. You have certain ri,Phts under b1.S. 13.04 (a.ailable upon request) to review private data on yourself. 6, Your full name is required to process this aoplica[ion or permic. � Firsc Middle �� Address - Ciry Stam Zip Phone I understand my ri�hts as stated above. / "� /�J Signature •