Data Subject Access Request form

First Name*

Last Name*

Which email address have you used to access our services*?

You are submitting this request as*:
The person mentioned aboveA third party, authorized by the person to make this request

I am submitting a request to*:
Receive a report about which personal data is collected by meHave my information changedHave my information deletedOther

If other, please specify:

I declare that*:
All the information above is trueI understand if I request to delete my data it is irreversibleI understand that I will need to supply an email address, in order to be contacted for this process

Do you have any comments to add?