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. . . � ` J Sec.13.Q4 RIGFiTS OF SVBTEGTS OF DAT?, - __ _ . . � Sutd. 1. Type oL data. The righcs of individual oc whom the data is srocsd or co be stored sha)I be u sec focch ia chis secriom • Subd.2. Intocmatiaa nquired to he givm iadividuat. an iadividuat uked to suPPIY Privare or coafideadal daa conceraing!►imself shaIl be infoc�ed o�: (a)the purpase aad iaceaded usc of the requured dan wichia the coIIecdng Etate ageary.poli6al subdivisioe.o�sncewide rystm; � - (b).whet�er h:s.ay r.hise or is legally requir:d m suppiy the requesc:d dst�:(cj any t�owa eoasequeaca uisiag ftnm his supptyiag or refusing w supply • . . privat�or eon.�der.ea.I dara;and(�[�e ideadry of ocher persoas or eaddes aucfiarized by sace ar fe�e�'L:u ta r.ceive the daa. This requiremeac shall �not apply wµea an icdividual Is uked to supply iavurigadve daa,pursaaac to secdoa 13.82.stibdivisioa S.oo a law eafoccemeat ofncer. .• . • � � T�ta cer.�rtsissiofttr Of revenue mav olae-•the noac� r�uird und•r this subdivision in the individual ineome ex oc orooertv eaz ceFi�ad insttueaons i.*uuad of an chose foems. ' • � . Subd.3. Access to data by iadividaal. Upon nquesc to a cespoasible auehodry,an individual sball be informed whe[her he is the subjeec ef stoc;d daa on individuals.aad whecher ic is tiassihed u public,priva�or eonE.deadal. Upoa his furcher zeques�aa iadividnal who is rhe subj:.c o!sioce�i privace ar publie daa on iadividuaIs shall be showa�he daa wirkout any charge to him and;if he des'ues.shall be infocmed ot the eoacenc aud meaaiag o[chat data. Afu�aa individual has beea shown the pdvatb dan ar.d iaformed o!ics meaning,the daa ne:d aot be disclosed oo him tor six moadis thereafmr unlas a d'ispuce o�acaon pursuanc to this secdon Is peading or addidoaal data on the tadividuat has been coUec�d or eceaced. The cesponsibte authoriry shallprovide eopies ot the privu orpublic dara upon request by the iadividuaI subjece of the dam. The respoan'bie aucfloriry_ may cequire the requescing pe�son to pay che acacal cosu of makiag,eerafying,aad comp�ing the eopiu. ' The responsible auchoriry shall eomply immediacety.if possibie,wich aay tequat made pursuanc w this subdivision,o�wi�hin five days of the date of die requa�excluding Sacurdays.Sundays and tegal hatidays,if immediate complianee is not pou3te. If he eanaoc comply with the tequesc wi�hin that dcue,he shall so inform rhe indlvidual,and may have an addidoaal five days withia which to eomply wich the requa�excludiag Saturdays, Sandays and legal holidays. � . . , - , Su�d.4. �roeedure whw data Ls nat accuratt or complete. M iadividaal may eontut the aetunry oc eompleteaess a[publlc orprivace data eoneeming htcaself. To ezeccix this cight,ae individuai shaIl nadFy la wridng the cespoasibte authoriry dactlbiag the aature olthe disagreemeac The cespoasible auehoriry shall wichia 30 days either. (a)eornect rhe dara taund to be inaccunre oc uuomptete aad aaempc w nodfy put reeiplencs of inaccucue or Incomptece daca.including«cipiencs narised by che individual;or(b)nadfy the lndividual that he believes dse dara w be cocreet Dati ia dispace shall be d'uciosed onIy if the individaal's sacuaenc oi dtugreem:at is included wirh the disdoud dam. . Zhe determinadoa o!the responsible auchoriry may be appealed pursuanc to the provitions of the adminisaadve pcacedum aa retaaeg to contesed casas. ' . • • � • � pATA PRIVACY ADYISORY ' � In accordance with M.S. 13.04,Subd.2, "Ri�hhts of subjects of data".we would like to inform you that your request for a peraut or Iicense from the Ciry of Orono or any of its depaztments may require you to furnish certain private or coafidential information. You aze notified that: 1. The information you furnish wilI be used to determiae your qualificadon for the permit orlicense requested. 2. You may refiue to suppty data, but refusal may require that the City deny the permit or license. � � 3. The informatioa may be shazed wich o�her local,s[ace or federal asencies to the excenc necusary to process the permit or license. � 4. If your requested permit or license requira Council actioa to approve, some information may become . pubtic. ' � • . �. � • .. � � � . . . .'S. You.have certaia rights under M.S. 13.04�(available upon requat) to review private data on.yourself. . . _ . 6. Your full name is required to process this application or permic. Fusc • �tiddle Last • _ . _.....,. Addc+ess � C«Y , Stue Zip Y�oae I underscand my scated above. Signamre • .