Accessing your personal information - subject access request

Subject Access Request Form


* Denotes a required field

About You

Title


* First Name


* Surname / Family Name


Previously Known As (if applicable)


* Current House Number / Name


* Current Road / Street


* Current Town / City


Current County


* Current Postcode


Date of Birth


Telephone


* Email





Details Of The Person The Request Is About (Data Subject)

Copy address details from above

Title


* First Name


* Surname / Family Name


Previously Known As (if applicable)


* Current House Number / Name


* Current Road / Street


* Current Town / City


Current County


* Current Postcode


* Date of Birth


Telephone


Email






Previous Addresses

House Number / Name


Road / Street


Town / City


County


Postcode


From


To


House Number / Name


Road / Street


Town / City


County


Postcode
From


To







Additional Information

* What Is Your Relationship To The Data Subject?


What Legal Authority Do You Have To Request The Data Subject's Information?



Is The Request Subject To An Exemption, Please State The Exemption And The Reasons Why It Would Apply


* If the data subject is under 16, do you have parental responsibility for them?





What Information Are You Requesting?

To speed up the process and reduce delays please provide as much information as you can to help us locate the information you are requesting.


* Which Department/Service Are You Requesting The Information From?


* Which Time Period Does Your Request Cover?


* Description of the information you want to see (include any known ref numbers)


Please upload proof that you can act on the persons behalf e.g. written authority


* We will need proof of your identity and residence before we can release any information

Proof of your identity (eg, scan of current passport, current driving licence, birth certificate, adoption certificate)


Your proof of residency. (must be dated within the last 6 months and show your current address. Council tax statements must be dated for the current year)









Data that you provide through this form will only be used for the purpose of identifying you and locating your records, and for administration of your request. It will be kept securely and only shared with you and any authorised third parties. For more detail on how the Council manage your data, including your rights and how to complain, see www.hackney.gov.uk/privacy

Page updated: 24/05/2019 06:49:07