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E , _ � <br /> � Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himself shall be <br /> informed of. (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the idenrity of other persons or entities authorized by state or federal law to receive the data.T'his requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav olace the notice reauire�under this subdivision in the individual income tax or orocertv tax refund <br /> insiructions instead of on those forms. <br /> Subd.3.Access to data by individual.Upon request to a responsible authority,an individual shall be infom�ed whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or wnfidenrial. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be infortned of the content and <br /> meaning of ihat data. After an individual has been shown the private data and informed of its meaning,the daffi need not be disclosed to him for six <br /> months thereafter unless a dispute or acuon pursuant to this section is pending or additional data on the individual has been collected or created. The <br /> responsible suthority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority <br /> may require the requesting person to pay the actual costs of making,certifying and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of <br /> the date of the request,excluding Saturdays,Sundays and legal holidays,ifimmediate compliance is not possible.Ifhe cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, <br /> Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete.An individual may contest the accwacy or completeness of publ ic or private data <br /> concerning himself.To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.The <br /> responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The detemtination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act reladng to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request <br /> for a permit or license from the City of Omno or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You aze notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. <br /> 3. The inforrnation may be shared with other local, state or federal agencies to the extent necessary to <br /> process the permit or license. <br /> 4. If your requested permit or license requires Council action to approve,some information may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. <br /> 6. Yow full name is required to process this application or permit. <br /> �/� �/ u'`2�J ,t1 l�/�'?���r,� . <br /> First Middle Last <br /> r <br /> Address <br /> City St9te Zip Phone <br /> I understand my rights as stated above. <br /> � � �� � <br /> Signature <br /> t4w � �«�§° 5�sr� ta��f �, '� x' " <br /> tf 5;�,� � �� � �,� , �, ;F ;? 32 <br /> � <br /> �' ,E. , . � � .. ._� , <br />