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Scc 13.04 RIGHTS OF SI�BJE("I'S OI�DA"I�A <br /> tiubd I. l�ype of data �I�hc rights of individual on�vhom U�e data is storcd or to bc storcd shall bc as sct ti�rth in this scclion. <br /> Subd-2 Information requircd to bc givcn individual. nn individual ask�d ro supph�privatc orcontidcntial dm.i conccmmg himsclfsh��ll bc <br /> informed of: (1)the purpose and intended use of the requcsted data���ithin Uie collecting state aeenc��.political subdivision,or state�a�idc svstun_(b) <br /> �chether he ma��refuse or is legally required to supply thc requcsted data:(c)any kno�cn consequence arisine from his supplYing or refusing to supply� <br /> pri�at�or cont idential data:and(d)the identity ofother persons or entities audiorized by st�te or federal la�c to reccive the data. ��his requiremcnt shal I <br /> not appl��chen an individual is askzd to suppl}�investigative data,pursuant to s�ction 13.82.subdicision 5.to a law entorcement officer. <br /> l�he commissioner of revenuc mav olace the notice required under this subdicision in the individual income tax or proqcrty ta�re�und <br /> instructions instead of on those fonns. <br /> Cnhri 3 Ar�rev fi data hv in�liviriiial I Inrn�rernie�Stt�a r�snnnvihl�anth�rit�� an in�iividnal tihall h��inf�nnP�i whPtherhe iethe¢nhirct�if <br /> stor�d data on indi��iduals_and�ched�er it is classificd as public,pnvate or confidential Upon his tiuthzr r�yuest an individual who is the su�ject of <br /> stored pri��ate or publ ic data on individuals shall be shown the data without any charge to him and_if he d�sires.shall be informed of the content and <br /> meaning of that data. After an individual has been shown the private data and infonned oY its meaning.thc data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the indi��idual has been collected or created 'The <br /> responsible authoriq�shall provide copies of the private or public data upon request by�the indi��idual subject of the data. The respoi�sible authority <br /> ma��require the requesting person to pati�the actual costs of making,certif��ing.and compiling the copies <br /> The responsible authorih�shall comply immediately,if possible.�cith an��request made pursuant to this subdivision,or within live days of <br /> the date ofthe request tzcluding Saturdays.Simdays and legal holidays,if immediate compliance is not possible- If he cannotcomply with the request <br /> �cithin that time_he shall so infonn the individual,and ma��have an additional tivz da��s�cithin�chich to comph��vith the request.e�duding Saturdays, <br /> Sunda��s and legal holida}�s- <br /> Subd -t. Procedure�ti�hcn data is not accur:�te or complete. An indi��idual mac contest the accurac�ur coinpleteness of publ ic or priv�ite data <br /> conceming himself. To��ercise this right,an individual shall notifj�in writing the rzsponsiblz authorih�dcscribing the nature ofthe disagreemenL �Che <br /> responsible authoritc shall�eithin 3U davs either� (a)corroct the data found to bc inaccurate or incomplete and attempt to notily past recipients of <br /> inaccurate or incomplete data.including recipients named by the individuul,or(b)notif��the indicidual that he believes the data to be correcL Data in <br /> dispute shall be disclosed onl��ii th�individual's statem�nt ofdisagrcement is included�cith the disdos�d data. <br /> 1'he detennination of the responsible authority may be appealed pursuant ro die�rocisions of the administr�uivr proccduro act rclating to <br /> contested cas�s. <br /> DATA PRIVACY ADVISORY <br /> ln acairdance with M.S. 13.O4.Subd.2."Riehts��f subiects o��data".���c���<iuld like to intiirm�ou lhat v��ur reauesl <br /> tur a permit or license i�rom thc�'ity of Urono or an� of its depurtments ma}� reyuire��ou tu furnish ccrtain privatc ur <br /> confidcntial information. <br /> You are notified that: <br /> l. The information you t�urnish will be used to determine ��our qualitication for thc permit or license <br /> requested. <br /> 2. You ma} refuse to supply data,but refusal ma�require that thc Cit}�dcm�the permit or license. <br /> 3. The information may be shared with other local. state or federal agencies to the extent neccssary to <br /> process the permit or license. <br /> �4. If vour requcsted permit or license cequires Council action to appro��e. some information may become <br /> public. <br /> 5. You ha��e certain righls under M.S. 13.04(available upon requcst)to re��ie���private data on yourself. <br /> 6. Your full namc is reyuired to process this application or permit. <br /> �c�SI��-� ..� S'G�c���,�►,�., ;,C�.�-- <br /> First Middle I.;�st <br /> �l 4 q G✓ SC� �r h �'•� ; # 7 S `Z <br /> ���r�titi <br /> ��i s .�,r/ s S y�o 95z�Zq�-���S� <br /> Cih� State 'I,ip Phonc <br /> 1 understand my rights as stated above. <br /> �, �..._--._._,�--.°--�- ` _ <br /> Sig ature <br /> Reset Form 32 <br />