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� <br /> Sec.13.04 RIGIiTS OF SUBJECTS OF D�Ta <br /> Subd. 1. Type of data. The righcs of individual on whom cha dara is s�:=3 or�a be stored shall be as set forth ia this secdoa. <br /> Subd.2. Information reqirired to be given individual. An indi�idual azk�tn suPPtY private or confidendal data concerning himself shall <br /> be informed of: (a)the purpose and intended use of the requestcd data w:�ia che coIIecring"state agency,polidcal snbdivisian,or statewide rystem; <br /> (b)whecher he may refuse oY is legally required�o supply che requested dan:(c)anY l�own coasequence arising from his supplyin8 or refusing to suppiy <br /> privaco or conndendal data;and(d)the idenriry of other persons or enudeT�C[h�oriz=do�13 82 subdivis on 5 o aelaw�enforcemenc o�c�emenc shall <br /> noc appiy whan an individual is asked to supply invesdgadve dara,p <br /> Thz commissioner of rovenue mav lace the nodce reauired cr.der this subdivision in che individuai income tax or oro em tax refund <br /> instructions instesd of on those forms. <br /> Subd.3. Access to data by indiridual. Upon requcsc to a respoasible aechoriry.a on hislfurcher reques�an�iadiv duatewho s the ubjecc <br /> of stored data on individuals, and whe[her it is classified as public,priva`ar conE�d�� to h��d;if.he desires, shall be informed of the cont�nt <br /> of score�privace or public data on individuals shall be shown�he daca wiu ouc any c'1°� <br /> and meaning of chat au ess a dis u edor`ac on pubrsua�ho this�secdon s tending or ad oaal da eon�the indrvidual has been o�iie�ua or���d� <br /> six monchs�hereacter P <br /> 'ihe responsible au�horiry shali provide copies of che private or public daca c�on reques:by che individual subject of che dara. The responsible authonry <br /> may require the requesdng person to pay che actual coscs of makin¢,cer�ing, ar.d compiling the copies. <br /> 'Ihe responsible au[horiry shall comply immedia[ely,if possibl=,wi[h any r=quest made putsuant to this subdivision,or within five days of <br /> the date of the e heeshall so inform ch emdi idual aand may have�an ddiricr.31 five da;s�w'tthin which co comply wi[h the cequest exclud'g Saturdayst <br /> wirhin chat nm . <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. �n indivitual tnaY contest the accuracy ar completeness of public or private <br /> ast reci ienu of <br /> dara conceming himself. To exercise chis righG an individual shall aodfy ia wridng 'e.e responsible authoriry describing che naa►re af the disagceemenc. <br /> The responsible au[horiry shall withia 30 days either: (a)correct the data icund to be in���e�dividual that`h bel evesthe dataato be cacrecG Data <br /> inaccura[e or incomptete data, inctuding recipients named by[he individi=I;or(b)noafy <br /> in dispuce shall be disclosed only if the individual's statement of disagtee�=nt is i.c:_ded with the disclosed dara. <br /> The de�arminarion of che responsible auchoriry may be appeai==pursuacL to che provisions of the administrarive proceduro acc reladng co <br /> conresced cases. � <br /> DAT� PRIV�CY AD��ISORY <br /> In accordance with M.S. 13.04, o f Orono or any ot is,depar�ents�may equ re you of furn sh certa n�pr va[e or <br /> for a permit or license from the C ty <br /> confidencial informa[ion. <br /> You are notified that: <br /> 1, The information you fumish will be used to de:ermine�our qualification for the permit or license requested. <br /> 2, You may refuse co supply data, but refusal nay require that theC ity deny the permit or licens o rocess <br /> g, The information may be shazed wi�h ocher loc�l, stace or federal a encies to the exten[necessary P <br /> the permit or license. <br /> 4, If your requested perm.it or license requires Council action to approve, some information may become <br /> . . , . public. � ourself. <br /> �, You have certain ri�hts under M.S. 13.04 (available epon request) to review private data on y <br /> 6, Your full name is required to process this apolicacion or perm.ic. <br /> ��.� 1 � - ,- <br /> 'r^� �� t t.�t <br /> Firsc % , <br /> .�.. <br /> Addres� '1� �' S��C�. (�% "'`-�" <br /> ^ ' � Phone <br /> Y S�ace Z�P <br /> Ciry <br /> I understand my ri;hts as stated above. � <br /> Signacure <br />