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Sec.13.Q1 RIGHTS OF SLJBJECTS OF DaTA Subd. 1. Type of data. 'Ihe righcs of individual on whom the data is scored or w be scored shall be as set for[h ia this section. Subd.2. Information reqirired to be given individual. An individual asked w supply private or confidendal data conceraing himself shall be informed of: (a)the purpose and inrended use of the rsquesred data wirhin the collecdng�tatt agency,polirical subdivision,or sratewide rystem; (b)whether he may tefuse oY is legally required to supply the ceques[ed data:(c)any�own consequeace arising from his supplying or refusing to supply private or conndendal dara;and(d)the idenury of o[her persons or enddes authorized by sta�e or federal law to receive the data. This requirement shall noc apply when an individual is asked to supply invesrigadve dara, punuanc to secrion 13.82, subdivision 5, to a law enforcemenc o�cer. The commissioner of re�enue mav ala� the nodce reouired under this subdivision in the individual income taz or�rovertv taz refund insttucuons instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individua!shall be informed whether he is the subject of scored dara on individuals,and whecher ic is class�ed as public, private or confidendal. L;pon lus further request,an individual who is[he subjecc of scor.d private or public dara on individuals shall be shown rhe data wirhout any charge to him and,-if he des'ues, shall be infocmed of the content and meaning of[hat dara. After an individual hu been shown[he privatt data and informed of its meaning,the data need not be disclosed[o hitn for six mon[hs thereafrer unless a dispute or acdon pursuanc co [his secdon is pending or addirional data on the individual has been collected or created. The responsible auchoriry shall provide copies of the private or public data upon request by the iadividual subject of the dard. The responsible au[horiry may require che requesring person co pay the acaial cosu of making.cerdfying,and compiliag the copies. The responsible auchoriry shall comply immediatety,if possible,with any requesc made pursuant to this subdivision,or wichin five days of the dace of the request,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he canaot comply with the reques[ within that time,he shall so inform the individual,and may have an addiuonal five days within which to comply with the request,exctuding Samrdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compteceness of pubiic or private dara conceming himself. To exercise this right,an individual shall nodfy in wridng[he responsible authoriry describing the nanire of the disagreement. The responsible au[horiry shall within 30 days eicl:er: (a)correct ehe data found to be inaccucace or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, inciuding recipiena named by the individual;or(b)noafy the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's staument of disagreement is included with the disciosed data. The decerminadon of the responsible auchoriry may be appealed pursuant to the provisions of the adaunistrarive procedure act reladng to concested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or confiden[ial information. You are notified that: 1, The information you fumish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusat may require that the City deny the permit or license. 3, The information may be shared with other local, state or federal a�encies [o the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. �, You have certain ri?hts under M.S. 13.04 (available upon request) to review private data on yourself. (, Your full name is required to process this application or permit. d..t,�c \ ��`tL— Fi �iiddle Lasc �`?�. �� 4�33 � Address �t 1 C��,, �v �)�,.��-L Ciry State Zip Phone I derstand my ri�hts as stated above. Signature