Serving parts of North West London and the Home Counties.

Subject Access Request

Under the Data Protection Act 2018 you have the right to request any personal information we may hold about you.

This form is not mandatory but is designed to speed up the process. Subject Access Requests made in other written formats will be accepted.

Fields marked with * are mandatory.

    Part 1 - Your details

    Title *
    Surname *
    Forenames *
    Address (including postcode) *
    Customer Reference Number *
    Telephone Number *
    Email Address *
    Date of request *
    In case we have a query about your request, how would you like us to contact you? (select preferred method) *

    Part 2 - Proof of your identity

    Please provide copies of 2 forms of identification from the following lists. 1 from List A and 1 from List B. The copy will be reviewed by our Legal team and securely deleted immediately. The copy will not be held or stored on our records. Please refer to our privacy notice for more detail on how we look after the personal data we hold.

     

    List A                                                         List B

    Birth Certificate                                         Bank/Building society statement 

    National Identity Card                               Council tax bill

    Passport

    Photo driving licence

    List A document *
    List B document *

    Part 3 - Details of personal details requested

    To help us process your request quickly and effectively by providing as much detail as possible about the information you require.

    Details you require *

    Part 4 - Declaration

    By completing this form, I certify that details given are to the best of my knowledge true and correct. I understand that it is a criminal offence to obtain or disclose personal information unlawfully or to attempt to do so.

    I agree

    If you are acting on behalf of someone else (please ignore if not applicable) I enclose evidence of my authority to act on their behalf.

    I am making this request on behalf of the person whose details are given on this form in my capacity as (choose from the list below):

    Evidence of authority
    Relationship
    If you selected other, please specify
    Name of applicant/representative
    Date

    Part 5 - Sending this form

    Before sending this form please check you have:

    The information provided in this form will be used to process this request and additionally update your personal details held by us where relevant.

    If you have any queries or require any assistance completing this form, please refer to our Privacy Notice or contact us at using the email noted above.