SECTION 1: Details of the person requesting information
Full Name * Address * Contact Telephone Number * Your E-Mail Address * SECTION 2: Are you the data subject?
Data subject? *
YES: I am the data subject. I enclose proof of my identity (see below). (Please go to Section 4) NO: I am acting on behalf of the data subject. I have enclosed the data subject’s written authority and proof of the data subject’s identity and my own identity (see below). (Please go to Section 3)
To ensure we are erasing data of the right person, we require you to provide us with proof of your identity and of your address. Please supply us with a photocopy or scanned image (do not send the originals) of one or both of the following:
1. Proof of Identity (passport, photo driving licence, national identity card, birth certificate)
2. Proof of Address (Utility bill, bank statement, credit card statement (no more than 3 months old), current driving licence). If we are not satisfied you are who you claim to be, we reserve the right to refuse to grant your request.
SECTION 3: Details of the data subject (if different from Section 1)
Data Subject Full Name Data Subject Address Data Subject Contact Telephone Number Data Subject E-Mail Address * SECTION 4: Reason for erasure request
Please select the appropriate box (required): *
You feel your personal data is no longer necessary for the purposes for which we originally collected it. You no longer consent to our processing of your personal data. You object to our processing of your personal data as is your right under Article 21 of the GDPR. You feel your personal data has been unlawfully processed. You feel we are subject to a legal obligation of the EU or Member State that requires the erasure of your personal data. Other...
SECTION 5: What information do you wish to erase?
Please describe the information you wish to erase. Please provide any relevant details you think will help us to identify the information. Providing the URL for each link you wish to be removed would be helpful.
Also, please explain, if it is not abundantly clear, why the linked page is about you or the person you are representing on this form.
Please note that. In certain circumstances, where erasure would adversely affect the freedom of expression, contradict a legal obligation, act against the public interest in the area of public health, act against the public interest in the area of scientific or historical research, or prohibit the establishment of a legal defence or exercise of other legal claims, we may not be able to erase the information you requested in accordance with article 17(3) of the GDPR. In such cases, you will be informed promptly and given full reasons for that decision.
While in most cases we will be happy to erase the personal data you request, we nevertheless reserve the right, in accordance with Article 12(5) of the GDPR, to charge a fee or refuse the request if it is considered to be manifestly unfounded or excessive. However, we will make every effort to provide you with the erasure of your personal data if suitable.
What information do you wish to erase? *
SECTION 6: Declaration
Please note that any attempt to mislead may result in prosecution.
I confirm that I have read and understood the terms of this subject access form and certify that the information given in this application to Unicis.Tech is true.:
I understand that it is necessary for Unicis.Tech to confirm my/the data subject’s identity, and it may be necessary to obtain more detailed information in order to locate the correct personal data.
Confirm Agreement? Documents which must accompany this application:
- Evidence of your identity (see section 2).
- Evidence of the data subject’s identity (if different from above).
- Authorization from the data subject to act on their behalf (if applicable).
- Justification for erasure of data (see section 4)
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