Request for Personal Information | East Herts District Council

Red asterisk denotes a required answer.

1) Requestor

First name(s)

Last name

Job title

Organisation

Address

City/Town

ZIP/Postal Code

Telephone

2) Data subject

First name(s)

Last name

Address

City/Town

ZIP/Postal Code

Other identifying information

3) Description of personal data requested

Please outline the personal data that is being requested

4) Purpose

Please state why it is necessary to disclose personal data

Please state the relevant Schedule 2 Part 1 exemption under the Data Protection Act 2018 that you are relying on

How would not providing the information requested prejudice the purpose?

5) Lawful basis

Please provide an Article 6 lawful basis for processing general personal data.

(Please state if not applicable)

Please provide an Article 9 condition for processing special category data.

(Please state if not applicable)

Please provide evidence of this for example, if relying on public task reference the applicable legislation

6) Subject Access Requests

Please confirm if details of this request can be disclosed to the data subject under a subject access request or where a data subject is exercising their information rights?

7) Declaration and Authorisation

The authorising officer must be of the rank of police inspector or higher and for other 'relevant bodies' a senior officer or manager

Declaration

I certify that:

Information requested is compatible with the purpose in section 4 and will not be used in a way that is incompatible with that purpose
The information provided on this form is correct
I understand that if any information given on this form is incorrect, this can be an offence under section 170 of the Data Protection Act 2018.

I have read and understood the above Declaration

This form will automatically be sent to the Council's Data Protection Officer.