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� Sec.13.04 RIGHTSOFSUBJECTSOFDATA <br /> . � . <br /> Subdivrsion 1. Typt ojdata The rights ojrrulrvidual on whom the data fs stored o�to be sto�ed sha11 be as set jorlh fn fhis sec�ion. <br /> Subd 2. Injormadon requirtd to be glven individua[ An individual asked ro aupply private or confrdenfia/data concerning hlmselj <br /> sha//be info�med oJ.• (a)the purpare axd rntended use of the�eques�ed dota wr�hin the co!/ecting slate agency,polierca!subdivrsion,or statewide <br /> system;(b)whether he may refuse or is legally required to supply the requested data;(c)arry known coxsequence arLsing from his supplying or <br /> �efuaing�o sr�pply privote or confrdential data;and(d)the iden�iry of other persona or entities authorrzed by state orjedera/law to receive the dato. <br /> Thir requirement shal/not apply when an individual ts asked to supply imestigative data,pursuant to sec�ion 13.82,subdivision S,�to n law <br /> enjorcement o„�'icer. <br /> 7he commissioner ot revenue mav nlace!he notrc¢reaaired uxdes�his subdivision!n 1he indivrdual income Jax or n�oner�v tax rehurd <br /> Instruc�rons rnstead olon those tosnu. <br /> Subd.3.Access to data by indlviduaL Upon request to a nsponsrble autho�iry,an individuol shal/be rnformed whether he is�he subject <br /> of slored data on individuals,and whe�her it Rs classif+ed as public,private or coxfrdential. Upon his further reques�,an individua/who!s the <br /> subject ojstored priva�e o�public dafa on indivlduals sha/l be shown�he da�a withou�any charge to him and,if he desiies,shall be injormed oJ <br /> the content and meanrng of that data. AfJer ax individual has been shown the private dala nnd fnjormed oj its meaning,1he data need nol be <br /> disclased to him fo�six mon[/u�herea,Jter uxless a dispeete or action pursuant�o this sectron is pending or addrtional data on the indfvidual has <br /> been co/lected or created The responsible authwity sha!/provide copies ojthe private or public data upon request by the indivklual subject of <br /> the data The nsponaible au/horiey may requin the requesting person to pay the aclual costs of making,cert�i»g,and compiling the copies. <br /> The respoxsrble authoriry shall comp/y immediately,ijpossible,wi�h ary request made pursua»t�o this subdfvision,or within ftve days <br /> of the date of the request,excludixg Satwdays,Suxddys and legal holidays,rf immediate compliance ls xot posaible. If he cannot comply with�he <br /> request withix that trme,he shall so injorm lhe individual,and may have on addrtional frve days wtthin whicA to comply wrth�he�equest,exclading <br /> Salurdays,Sandays and lega!holidays. <br /> Subd 4.Proctdu�t whtn data Lr not accurale oi comp/ete An indivrdua!may con�eat the accuracy or completeness oJpublic orp�ivate <br /> data conce�ning himself. To exerclse�his right, an indivrdual shall no��in writing the responsib/e authorrty describing the xalure oJ fhe <br /> disagreement. The responsible authority sha!!wilhi»30 days erther. (aJ comct�he datafound Jo be inaccura�e or ixcomplete and aftempt to not� <br /> pcut reciptents ojinaccurate o�tncomp/ete data,lncluding recfptents named by�he indfvfdual;or(b)nol�rhe individua!that he belteves�he data <br /> to be correct Data In dispu�e sha/1 be dlsclated only ff tiie indtv/dual's statement oJdisagreemen�is included wrth the drsclosed data. <br /> • The determi�ratlon of the responsible authority may be appealed pursuant to the provistons of the adminisbative proceduse act�elatrng <br /> �o con�ested cases. <br /> DATA PRIVACYADVlSORY <br /> Inaccordance wlth M.S.l3.04,Subd 2,"Rights ofsubjecta ofdata",we would lfke to injwmyou thatyourrequesJfor a permi�o�license <br /> from�he City ojOrono or a�ry oji�s depastmexrs may nquire you to furnrsh certain p�ivate or confrdentia!ixformatfon. <br /> Yoa are notified that: <br /> /. The informa�fon you furnish will be rued to deternri�your qualrficc�ron fos the permit o�license reqaested <br /> 2. You may refuse�o supply data,but refusal may reqube�hat�he Cfty deny�he pernrrt or licerae. <br /> 3. The informatfon may be shared wfth ofher local,state or federa!agencres to the extent necessary to process the permtt or <br /> license. <br /> 4. !f yorir reqaested permit or license requires Council action to app�ove,some information may become public. <br /> S. You have certain righls under M.S.13.04(see Jollowing pogeJ to revieiv p�ivate data ox yourself. <br /> 6. Your full name is required to p�ocess this applica�ion or permit. <br /> PLEASE PRINT <br /> ��'�.i 2 .^ � • I:7c� f <br /> First Mtddle Last <br /> � I�LO �+�c�c� C nr� �C �S'cc.t.._ <br /> Address <br /> ��t�,z �:� ht/v .S� �s � C�f�..�-�-1 $��f/ <br /> City Slate Zip Phone <br /> I underatand m ighls as stated above. <br /> ,.�. <br /> Sfgnature <br /> 10 <br />