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Sec.13.0�3 RIGFTTS OF SUBJECTS OF D.�►Ta Subd. 1. Type of data. The righa of individual an whom che dara is stored or m be swred shall be as set forth in chis section. Subd.2. Information reqirired to be gvm individual. .�n individual asked w supply privau or confidenrial dara concerning himself shall be infotmed of: (a)the purpose and inrrnded use of�he requesred data within�he collecdng 3tate agency,polidcal subdivision,or statewide rystem: (b)wherher he may refuse ot is logally�equiczd w supply rhe requesced dara;(c)any irnown wauquence arising from his supplying or reCusing to supply privare or confldendal data;and(d)che ideariry of o�er pecsoas or enrides au[horized by uace or federa!law to mceive che daca. This requuemenc shall not apply when an individual is asked to suppty iavesrigadve dacn,pursuanc to secrion 13.82,subdivision 5,to a law enforcemenc officer. The commissioner of re�enu mav ola- rhe nodce reauired under rhis subdivision in the individual income rax or orooem taz refur.d insnvcaons inscead of on fiose forms. . Subd.3. Aecess to data br-individuaI. lipon czquac to a responsible aurhoriry,an individual shall be informed whecher he is the subject of stor.d data on individuals,and whether it is clusified as public,private or confidendal. tipon his further request,aa individual who is the subjecc of scored privace or public data on individuals shall be shown die dara wi[hout any charge tn him and:if he desires,shall be informed of the concenc and meaning of chat data. After an individual has been shown che privare data and informed of its meaniag,che data need not be disclosed to him for six monrhs rhereafter unless a dispute or acdon pursuanc to ehis section is pending or addidonal dara on rhe individual has been collecud or creaud. The respansible au[horicy shall provide copies of dte privare or public data upon request by[he individual subject of che daa. The responsible aurhoriry may require che requesting person m pay e1►e acnial coscc of making,cerdfying,and compiling the copies. The responsible auehoriry shall comply immediacely, if possible,wich any reQuat made pursuant to this subdivision,or wirhin five days oi the dace of the request,excluding Saturdays.Sundays and legal holidays,if immedia�e compliance is noc possible. If he caanot comply with the requesc wi�hin rhat time,he shall so inform che individual,and may have an addiaonal five days wichia which to comply with the tequest,excludiag Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is aot accurate or complete. An individual may contest the accuracy or compleceness of public or pri�ate - dara concerning himsdf. To exercise chis righc,an individual shail nodfy in wridng the responsibie aurhoriry describing ehe nacure of che disagreemenc. . The cesponsible auchoriry shail wichin 30 days eid:er. (a)correcc the data found ro be inaccurdce or incompleu and aaempt co n�dfy past recipienes of inaccurate or incomplete dan,including recipiena named by[he individual;or(b)nodfy the individual thac he believes the dara to be correct. Dac� in dispute shall be disc:osed only if che individual's sratement of disagreement is inciuded wirh rhe disclosed dara. The decerminadon of the responsible authoriry may be appealed pursuant w the provisions of ehe adminisaarive procedure act retacing to contesced eases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2, "Righu 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 furnish certain private or confidential information. You are notified that: 1. The information you furaish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply da[a, buc refusal may require that the Ciry deny the permit or license. 3, The information may be shared wi[h ocher local, state or federal agencies to 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. �-rQ � �r,�� (�f �� First �tiddle Last d�0`e$ � �'� �� Address �S`'{�-{ � �p � Z'�l a —ri� 1 a ��I�.A� Cicy Stace Zip Phone I understand my ri;hts as staced above. . �� s�g��,R