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� <br /> Sec./3.OJ R/GHTSOFSUBJECTSOFDATA <br /> Subdivision/. Type ojdat¢ The rights of individual on tivhom the data is s�ored or�o be sfored shall be as set jorlh in�his section. <br /> Subd 2. lxjo�mation required to be given individuaL An individual asked 10 supply private or confrdentia!data concerning himself <br /> shalf be injormed of (nJ�he purpose and intended use ojlhe reques�ed dalo within�he collec(ing slale agency,poli�ical subdivision,or sta�eivide <br /> system;(b)whether he may rejuse or is lega/ly required lo supply�he requested dafa;(cJ any knotivn consequence arising jrom his supp/ying or <br /> refusing fo supply privale or confidenlia/da1a;and(dJ the identiry oJother persons or enfities aulhorized by s�ate orjederal!aw to receive�he data. <br /> This requi�ement shal!»o�appJy when an individua!rs asked to supply investigarive da�a,pursuan�to seclion 13.82, subdivision S, �o a!mv <br /> enjorcement o8cer. <br /> The commissione�o(revenue mav place�he notice reauired under this subdivrsion rn the indivrdual income tax or nropertv!ax refund <br /> irutructions inslead ofon those forms. <br /> Subd.3.Access to data by individuaL Upon request to a responsible authority,an individual shaJl be injormed whe�her he is the subject <br /> oJstored data on ixdividuals, and whe�her rt is classrfied as public,priva[e or confiden�iaL Upon hrs jurther request,an individuaf who rs the <br /> subject oJsto�ed privale or pub[ic data on individuals shalf be shoivn the data ivithou�any charge�o him and,if he desires,shall be informed oJ <br /> the content and meanrng oJfhal data.'Ajter an individua!has been shown 1he privnte da�a and injormed oJits meaning,1he data need no�be <br /> disclosed�o him jor six months the�eajter unless a dispute or aclion pursuant to lhis section is pending or additiona!data on rhe individual has <br /> been colfecled or created. The resporuibl¢authority shall provide copies oJ1he privale or public dala upon request by the individual subject oj <br /> the data. The�esponsible auchority may require the reques�ing person lo pay 1he actua!costs oJmaking,cerl�ing,and compiling[he copies. <br /> The responsib/e aulhority sha!!comply immediately,iJpossible,ivith any request made pursuanl�o thrs subdivisron,or tivithin five days <br /> oJ�he date oJthe request,excludrng Sarurdays,Sundays and lega!holidays,rf rmmedrate compliance is no�possible. Ijhe canno�comply ivi�h�he <br /> reques�within thar[ime,he sha!lso injorm rhe indrvidual,and may have an addrtiotral five days wi�hin tivhich�o comply ivilh�he requesl,excludrng <br /> Sarurdays,Sundays and lega!holidays. <br /> Subd.4. Ptocedure when dalals not accurale or cornplele.An individua/may conles�the accuracy or comp/eteness oJpublrc or private <br /> da�a concerning himself To exerclse�his right, an indivldua!sha/!nofify in tivri�ing�he responsible aulhority describing!he nature ojthe <br /> disagreement. The resporufble aufhoritysha!/within 30 days erther: (a)correcl�he da�ajound�o be inaccura�e or incomplele and at�emp��o not� <br /> plt,sf recipien�s oJinaccurate or incomplete da�a,incJuding reciplents named by Ihe individuol;or(bJ no��the individua!lhat he beJieves!he dala <br /> ro be correct Data in dispule shal!be disclosed only ij�he indivtdual's sla�ement of disagreement is included►vith�h¢disclosed da�a. <br /> The de�ermina�ion ojlhe responsible au�hority may be appealed pursuanf�o the provisions ojthe administ�ntive procedure act relnting <br /> to contes�ed cases. <br /> DATA PRIVACYADVISORY <br /> !n accordance with M.S.13.04,Subd.2,'Righ�s oJsubjects ojdala';ive ivould like fo injorm you Ihat your request for a permi[orlicense <br /> jrom the City ojOrono or any ojru deparlments may requrre you lo jurnish certain private or confiden�ial injorma�ion. <br /> You are notifred that• <br /> /. The injormation yon Jurnrsh will be used�o determine your qun/ificafion for the permi�or license reques�ed. <br /> 2. You may rejuse to supply da�a,but rejusa!may require�hat(he City deny the permit or license. <br /> 3. The information may be shared wlth o�her local,state or jedera!agencies�o the ex�enf necessary!o process the permit or <br /> license. <br /> 4. /Jyour requested permit or license requires Councr!action to approve,some informalion may become public. <br /> S. You have cer�ain righrs under M.S 13.04(see jollotiving pageJ lo revietiv priva�e daln on yourself. <br /> 6. Your ju[I name is required to process lhis application or permit. <br /> PLEASE PRINT <br /> First ' Middle Last <br /> Address <br /> City Slafe Zip Phone <br /> I unde�stand my rights ns stoled above. <br /> Srgnature <br /> !0 <br />