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w � <br /> - ., , , <br /> Sec.13.0�RIGE3TS OF SUBJECTS OF D?.T?. <br /> Subd. i. Type of data. The rig�cs of individual on whom[he data is scored or to be seDr.d shalI be u set forth in this secdon. <br /> Subd.2. InformaCon reqirired to be given indi�idual. An individual2sked to ntpply privare or confideaaal dara concerning him.self shall <br /> be informed of: (a)che purpose and imm�d:d use of the rcques�dam within the colle:dng Star�ageacy, polirical subdivision,o�sntewide rystem; <br /> (b)whe�her he may rfuse or is legatly requir_d to supply the rquested data;(c)any Irnown coasequeace arising from his supplying or refusing to supply <br /> privace or conndendal dara;and(d)the idandry of other persoat or enod:s aachoriz�d by scate or federat law to receive the dara. Zhis tequirement shall <br /> not app(y when an individual i5 asked to supply invcsrioadve dam,pursuaat to secdon 13.82,subdivision 5, to a law enforcemao�ofricer. - <br /> The comnission-r of revenue mav place �h- noace r�uired und-r this subdivision in the individuaI income cax or orooem az refur.d <br /> inscrucdons inscead of on chose forms. <br /> Subd.3. Access to data by indiridual. lipon request to a resQonsible auchority,an individual shall be informed whe�her he is the subject <br /> of scord data on individuals,and whecher it is ciass�:d as pubiic,privace or conFidential. Upon his furcher request,an individual who is[he subjecc <br /> of Stored privace or public data on individuals shall be shown the dara wichout any charge to tiim and,-if he desues, shall be infocmed of the concenc <br /> and meaning of chat dard. Ahzr an individual hu been shown�he privace data and informed oE its meaning,the data need not be disclosed to hi.m for <br /> six monchs tFereaiu.r uniess a dispute or acdon pursuanc to this secaon is pznding or addidoaal data on the individual has beea eollecced or creaced. <br /> The rsponsibta au�horiry shall pcovide copies of the priva[e or public data upon requesc by che individu�l subjecc of che dara. Tna responsible au�horiry <br /> may tequir the requesring peaon to pay the acnial costs of making,cerriFying,and compiling the copies. <br /> The responsiblt authoriry shall compiy immediattty,if possible, wich any requcsc made pursuant to this subdivision,or wi�hin five days of <br /> thc dace of che request,exciudir.g Sacurdays,Sundays and legal holidays,iF immediato compliance is not possible. If he canno�comply with the requesc <br /> wichin that dme,he shall so inform[he individual,and may have an addiaonal five days within which to comply wich the request,exctuding Saturdays, <br /> Sandays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accurdcy or comptetenzss of public ar pri�•ate <br /> dara conceming hinse(f. To exercise�his ri¢hc,an individual shall noa"ry in wridng che responsible authoriry dascribing the nantre of the disagreemeat. <br /> The responsiblc authoriry shall within 30 days eicher: (a)corr.cc[he data four,d to be inaccucate or incompiece and att:mpt to nodfy pasc recipients oE <br /> inaccura:e or incomplece data, inctuding recipiena named by the individual; or(b)nocify the individual that he betieves rhe data to be correcG Data <br /> in dispuce shall be disclosed only if rhe individual's sc3temen�of disagrcemen[is included wich[he disclosed dac�. <br /> Th�decerminadon of the responsible authoriry may be appealed pursuant to the provisions of the admicustradve procedure act reladn� to <br /> contesced cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04, Subd.2, "Ri;hts of subjects of data", we would like to inform you that your request <br /> for a permit or license from the Ciry of Orono or any of its deparcments may require you to fumish certain private or <br /> confidential information. <br /> You are no[ified that:• <br /> 1. The information you furnish will be used to determine your qualification for the permit or license requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the perm.it or license. <br /> 3. The information may be shared wich ocher local, state or federal a�encies to the extent necessary to process <br /> ' the permi[ or license. <br /> 4. If your reques[ed permit or license requires Council action to approve, some information may become <br /> public. <br /> 5, You have certain riQhts under M.S. 13.04 (available upon request) to review private data on yourself. <br /> 6. Your full name is required to process ihis application or permit. <br /> ,�� � ' <br /> �,'��C����S � 2��('�/ � - <br /> First , �h iddla Lasc <br /> l ��5 ������ ';��i���� t51 v�� - <br /> Address � !`� `� �\ � � � �"���' b�� � <br /> il�,J��11��� <br /> ry Srace Zip Phone <br /> I understand my ri�hts as stated above. <br /> �-�-'��-�� <br /> sfgnacuro — <br />