Request For Access To Personal Data

Javascript is disabled

Javascript is disabled on your browser. Please enable it in order to use this form.

Section 1

REQUEST FOR ACCESS TO PERSONAL DATA

DETAILS OF THE DATA SUBJECT

Name

Identity (ID) Number

Phone

E-mail address:

(Provide the following details where making a request on behalf of a minor or a person who has no capacity)

Name

Relationship with the Data Subject

Contact Information

DETAILS OF THE PERSONAL DATA REQUESTED

Describe the personal data requested*

Write Here

MODE OF ACCESS

I would like to:

Inspect the record

Listen to the record

Or Have a copy of the record made available to me in the following format:

Photocopy/ printed (Note that copying/ printing costs will apply)

Electronic

Transcript (Please note that transcription charges may apply)

Other

Specify format

DELIVERY METHOD

Collection in person

By mail (provide address where different / in addition to details provided above)

Town/ City/ Postal code:

By e-mail (provide email address where different / in addition to details provided above):

Email Address

DECLARATION

Note: Any attempt to access personal data through misrepresentation may result in prosecution.

I certify that the information given in this application is true.

Signature Pad

Date*

Select Date ×

Your form has been submitted

Thank you. We will process this and get back to you ASAP.

Server Side Error

We faced problems while connecting to the server or receiving data from the server. Please wait for a few seconds and try again.

If the problem persists, then check your internet connectivity. If all other sites open fine, then please contact the administrator of this website with the following information.

TextStatus: undefined
HTTP Error: undefined

Processing your request

Error

Some error has occured.