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Subject Access Requests
Step 1 of 5
20%
Please note, this form should only be used to request information about a living individual
I am the Data Subject (The person the information is about)
I am acting on behalf of the Data Subject:
I am acting on behalf of data Subject under the following authority:
The Data Subject’s written consent to disclosure of the information requested
A Court Order (e.g. Power of Attorney) permitting release of the information requested
If you are seeking information on behalf of someone who is unable to act for themselves, you must explain your relationship with that person, what information you require and why it is required. Please note that information relating to someone else will not be disclosed without the data subject’s written consent or an appropriate Court Order or Power of Attorney.
Proof of ability to request on behalf of another person.
Please upload proof of the item you have selected as proof
My relationship to the data subject is:
(Please specify e.g. Doctor/Solicitor/Spouse/Civil Partner/Father/Mother/Brother/Sister etc)
Part 1 - Data Subject Personal Details
Name
First
Last
Date of birth
Date Format: MM slash DD slash YYYY
Daytime Phone
Email
Address
Street Address
Address Line 2
City
County
Post Code
(if different from above). If seeking information on behalf of someone else please also provide your full name. Please also provide the address that you want the information sent to plus your daytime telephone number in case we need to speak to you to discuss the request
Name
First
Last
Date
Date Format: MM slash DD slash YYYY
Address
Street Address
Address Line 2
City
County
Post Code
Phone
Email
State clearly the information you require, with dates where known.
Please provide as much information as possible to assist us in locating your data.
Information Requested
*
Verification of identity is required before your request can be processed. If you have changed your name then proof of this name change will also be required in the form of marriage licence/deed poll certificate etc.
Identity Check
A copy of your photocard driver's licence OR
Your current passport showing photo and signature AND a copy of a recent domestic utility bill or official correspondence confirming current home address dated within the last 3 months
Please select the proof you are supplying
Proof of ID 1
Proof 2
Confirmation
*
I declare that to the best of my knowledge, the information I have provided on this form is correct
I understand that Our Lady of Lourdes Catholic MAC will use the information included in this form to process the request, which may include sharing it with third parties as defined in our privacy policy.
If you do not tick the boxes above, we will not be able to progress your application, and you will be required to resubmit the request.