Data Subject Access Request Form

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A 'Data Subject Access Request Form' can be written by the individual about whom data is held (the Data Subject), or the Data Subject can grant permission to another party to write the letter and represents their interests in this matter. Select 'the data subject themselves' if the person authoring this letter is the Data Subject themselves. The 'Data Subject' is the person about whom personal information has been collected and who is now requesting access to their personal. If 'the data subject themselves' is selected, the document will be written in the first person. Select 'an authorised representative of the data subject' if the Data Subject has nominated an individual to represent their interests in this matter with the organisation processing the personal data. The representative must demonstrate they have received the Data Subject's consent to act on their behalf. If this option is selected, the user will be required to provide the name, address and proof of identification for the representative.

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________,
________
email address: ________



________,
________

________



Re: Data Subject Access Request

For the attention of: Data Controller for ________

I, ________ (the Data Subject) am writing to request access to personal data generated or held by your organisation, whether that be in computer or manual form, concerning me. This right is exercised pursuant to Art 15 of the General Data Protection Act and the Irish Data Protection Acts 1998 to 2018 (the Data Protection Law).


Data Subject Information:

Full name: ________
Date of Birth: ________
Address:
________
Proof of address: utility bill
Proof of identification: copy of passport


Information Requested Pursuant to Art 15 of the GDPR (incorporated by the Data Protection Act 2018):

1. Confirmation that my 'personal data' as defined under Art 4(1) of the GDPR, is being processed by ________.

2. The location or locations where my personal data is being processed.

3. The different categories of personal data held about me, the Data Subject, specifically if the data held is categorised as: general personal data, 'special category' or 'sensitive' personal data or if it pertains to any legal or criminal record.

4. The purpose or purposes for which the personal data is being processed.

5. The respective rentention periods for each item or the whole of my personal data, and any criteria employed to determine the retention periods. It is recalled that the retention period should be no longer than is necessary for the purposes for which the data is processed.

6. The source or sources of the personal data held about me.

7. All parties within your organisation and all third parties to whom my personal data has been disclosed or been accessible.

8. Information about the existence of any automated decision making based on the personal data held, the manner in which those automated decisions are made and the consequences of those decisions.

9. Information about the existence of, and how to exercise the following rights under the GDPR:

a. the right to erasure;
b. the right of rectification;
c. the right to restrict processing;
d. the right to object


Specific Data Requested:

I request copies of ALL data pertaining to me held by your organisation in computer or manual form, including video footage, photographs, etc.

In particular, I request access to the following:

________

5 52 822285222 2552 252 252888822 22 252 82225252822 528528225 8888 222 822282 '5882522252822522 222252' 22 2255 252528852822. 5 52 5882 822285222 2552 252 5285282 88 222 '2528228282 522252525 25 258288882' 58 5228225 82 852 25 22 252 2828. 282582 8222582 22 58 8222 58 22888882 82 225 5285852 522 2552525 82225252822 22 822282 8825 22 5285282.

5 5228882522 5 52822282 22 2588 5285282 882582 2 (222) 22225, 58 52858525 82 252 52252222282225 8525 2522282822 258.


Kind regards,




______________________________________

________

The following document is being attached to the present Data Subject Access Request in order to prove the identity of the Data Subject: copy of passport

The following document is being attached to the present Data Subject Access Request in order to prove the address of the Data Subject: utility bill

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________,
________
email address: ________



________,
________

________



Re: Data Subject Access Request

For the attention of: Data Controller for ________

I, ________ (the Data Subject) am writing to request access to personal data generated or held by your organisation, whether that be in computer or manual form, concerning me. This right is exercised pursuant to Art 15 of the General Data Protection Act and the Irish Data Protection Acts 1998 to 2018 (the Data Protection Law).


Data Subject Information:

Full name: ________
Date of Birth: ________
Address:
________
Proof of address: utility bill
Proof of identification: copy of passport


Information Requested Pursuant to Art 15 of the GDPR (incorporated by the Data Protection Act 2018):

1. Confirmation that my 'personal data' as defined under Art 4(1) of the GDPR, is being processed by ________.

2. The location or locations where my personal data is being processed.

3. The different categories of personal data held about me, the Data Subject, specifically if the data held is categorised as: general personal data, 'special category' or 'sensitive' personal data or if it pertains to any legal or criminal record.

4. The purpose or purposes for which the personal data is being processed.

5. The respective rentention periods for each item or the whole of my personal data, and any criteria employed to determine the retention periods. It is recalled that the retention period should be no longer than is necessary for the purposes for which the data is processed.

6. The source or sources of the personal data held about me.

7. All parties within your organisation and all third parties to whom my personal data has been disclosed or been accessible.

8. Information about the existence of any automated decision making based on the personal data held, the manner in which those automated decisions are made and the consequences of those decisions.

9. Information about the existence of, and how to exercise the following rights under the GDPR:

a. the right to erasure;
b. the right of rectification;
c. the right to restrict processing;
d. the right to object


Specific Data Requested:

I request copies of ALL data pertaining to me held by your organisation in computer or manual form, including video footage, photographs, etc.

In particular, I request access to the following:

________

5 52 822285222 2552 252 252888822 22 252 82225252822 528528225 8888 222 822282 '5882522252822522 222252' 22 2255 252528852822. 5 52 5882 822285222 2552 252 5285282 88 222 '2528228282 522252525 25 258288882' 58 5228225 82 852 25 22 252 2828. 282582 8222582 22 58 8222 58 22888882 82 225 5285852 522 2552525 82225252822 22 822282 8825 22 5285282.

5 5228882522 5 52822282 22 2588 5285282 882582 2 (222) 22225, 58 52858525 82 252 52252222282225 8525 2522282822 258.


Kind regards,




______________________________________

________

The following document is being attached to the present Data Subject Access Request in order to prove the identity of the Data Subject: copy of passport

The following document is being attached to the present Data Subject Access Request in order to prove the address of the Data Subject: utility bill

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