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Sec,13.04 RIG�iTS OP'SUBJEC7�g pF DATA •
<br /> Suhd. 1, T�pe of�y, rnc righrs of indivi0ua!oo wham we aan is sconea_or co bc.�red sh�tt te as sec forth in chia tudon.
<br /> Subd,Z, Informatton required to be pvep Inditi•idual. An it�dividu�l asked�o supply p�va[e vr su�Jdondal dau eonceming himaei(th�li
<br /> be informod of: (a)the purpose and intended use of the requcs�od data wiehin the collecring Dvts agency,polidcal subdi�ision,or statewjdc rystem:
<br /> (b)whe[her he may rcfuso e�js legaily required��supply d,e rcquesred data;(c)any known consequencc arising from his svpplying ot t�cfusing to supply
<br /> privare or confidenrial dau:and(d)�he idcnriry uf othcrpersons or enuues auehorizcd by ccacc or federa(IaW�o rcce;ve t�e daw. This tequiremcnc shall
<br /> not dpply when an indiv�dual lt askcd co supply in�eatigad�e Ga�a,pursuanc co sccuon 13.82, subdivision 5, w a law cnfurcement ofGccr.
<br /> The cOmmissio r f revenu ma lace tht notice re Uirc under th' ub0ivision in he (ndi�iJ s! inco �ax or e ta, retund
<br /> inarrvccions inscna oF on[hosc forms,
<br /> Subd.3, pcceas to d�ta by indJv�dual, Upon reques�to a rzaponsibie 2uthoriry,an lndividuai slia]!be infotmcd�vhe�her he ia�he subjoct
<br /> of sroted daa on individuals,and whcchcr i�;s classified as public,pri�icc or confidencial. Upon hit funher rcquest,ati individual who it thc subjec[
<br /> of stoRd pri�ate or public dats on individu�ls shall be shown the dan wirhout any cl�aige to l�im and, if hc desires, shall be infoTmtd of the co�tent
<br /> xnd me4ning of rhat data, Aftcr an individual has bccn shown ihe privaco dau and in(ormcd af iu maning.�c dau need no�be diselosed to him for
<br /> si:months thereaher unless n dispute or action pursuanc to rhis section is pending or addicional dau on ihc indiv)dual has been collecced or ereatcd.
<br /> The responrible authority shall provide copios of the privei�or Dublic data upon requese by the indiv(duai subjcce of the daea. 7he responsible auehoriry
<br /> may rzquire the requesting penon to pay chc actual costs uf making, eertifying, and comritins Ne co�iea,
<br /> The responsible authoriry shall comply immcdiamly,if possiblo, with any requcsc made pursuant to Nis subdiviaion,or wichin five days of
<br /> the da�of che requcse,excluding SYtucdays.Sundays and legal holidays,if immcdia�e compli�nce is noc possible. If he cannoc comply with�he nqucsc
<br /> within�ttat time,he sAall sv iufocm ehe individuul,and msy havc an rdditiona!tve day:within which to comply wich the requcst,excluding Sacurdays.
<br /> Sundays aod Iegal holidays.
<br /> Subd.4. Proeedure vhsn data Is not accurate or eomptete. An inGi�idual nlay contesi U�c accurocy o�completenest oFpublic or prlvate
<br /> daa concemit�g himself. 7o exercise�his rig]tt,an individuat ahall notifr in writing�hc responsible awhutiry desctibing the naNre af the disagreement.
<br /> Tha nsponsible authoriry shall Wichin 30 d9yi eiclier: (a)co�recc ihe data found to be inaccurate or incomplete aod aaemp[to nocfy pasc rscipieuts of
<br /> inaccura�e or incomplete d�u, Including rcc;picnu namcd by the indi�idu�J:or(b)norify�he individual d�ar he believcs �he da[a to be corrccc. Daa
<br /> in dispute shall be discloSeC otily if the Individuat's swccment o(disagreetnene is;nctuded with thc discloscd dat8,
<br /> Tl�e dctcrtriuta[ion uf Q�e responsible suthoriry may be app��led pursuant to chc provisions of the adminis[tati�•e procedure act telaeing co
<br /> conuated casea.
<br /> AATA PRIVACY AD�ISORY
<br /> In accordance with M.S. 13.04, Subd.2, "Rights of subjects of dsta", wc w�uld likc to inform you that your request
<br /> for a permit or license from the City of Orono or any of i[s departmcnts may require you to furnish certain private or
<br /> confidcntial information.
<br /> You are notified that:
<br /> 1. The Informati�n you furnish wtll be used to determinc your quaii[ic�tion for tlie permit or liccnse requested.
<br /> ?• You may refuse to supply data, but rehisal may require tha� che Cicy deny the permit or licensa,
<br /> 3• 'Ihe lnformation may be shared with other local, state or federal ageneies to ehc cxcee�t nccessary i�proeess
<br /> the permit or liccnse,
<br /> 4- If your cequested permit or license requires Council xctiuii co appravc, suitie informacion may become
<br /> public.
<br /> 5• You have eenain rights under M.S. 13.04 (available upon requcst) tu revicw privatc data on yourself.
<br /> 6. Your ilill name is required �u process chis applicacion or permit.
<br /> Firs� Middlc L,ast �
<br /> Addncss
<br /> City S[ate .
<br /> Z�P Phone
<br /> 1 understand my righrs iu ststed above.
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<br /> $ignaNro
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