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Form for the exercise of the Right of Access
Form for the exercise of the Right of Access
Affected person’s or legal representative’s data
Name
*
I.D.
*
Address
*
City
*
Province
*
Zip Code
*
Email
*
How do you act?
I act on my own behalf
I act as a third person
Name
*
I.D.
*
Address
*
City
*
Province
*
Zip Code
*
Email
*
By means of this form I exercise my right of access, in accordance with what is provided of article 15 of Regulation (EU) 2016/679 of the European Parliament and of the Council, of 27 April 2016, relating to the protection of natural persons with regard to the processing of personal data and the free movement of such data (GDPR), request to be provided with the right of access to the personal data of which I (or my represented) am the owner and which are included in the files of THE COMPANY and in particular, I request access to:
*
The following specific data...
The data included in the file...
All of the applicant's data subject to processing.
The applicant chooses to receive the requested information through the following file consultation system (indicate one or more of them):
*
On-screen display
Written communication, copy or photocopy sent by post, whether registered or not
Telecopy
E-mail or other electronic communications systems
Any other system that is appropriate to the configuration or physical implementation of the filing system or to the nature of the processing, offered by the data controller
The information provided by THE COMPANY shall include the personal data of the data subject (or his/her representative) that are being processed, as well as the purpose of the processing, the category of data being processed, the expected retention period, the existence of automated decisions including profiling, the existence of the right to request from the controller the rectification or erasure of personal data or the restriction of the processing of personal data relating to the data subject, or to object to such processing, if the data have not been obtained directly from the data subject, the information available on the origin of such data, as well as the communications or transfers made or envisaged of such data including, where appropriate, those made to a third country or international organisation.
GDPR
*
I accept the
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