Access request form
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Access request form
Request a copy of personal data according to Data Protection Act 1988 and Data Protection (Amendment) Act 2003.
Important: A fee of €6.35, a photocopy of your proof of identity (e.g. passport or driver’s license and a photocopy of proof of address (e.g. utility bill) must accompany this access request form (see note below)
Section A – please complete this section
Full name……………………………………………………………………….
Postal Address
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Telephone*
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Email address*
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* We may need to contact you to discuss your access request.
Section B – please complete this section
I,………………………………………………………………… (insert name) wish to have access to data which I believe GeoDirectory retains on me as outlined below (please include the name of the services and any account/reference number relevant to your access request)
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Signed ……………………………………………………Date……………….
Checklist
Have you:
- Completed the access form in full?
- Attached a photocopy of proof of your identity and address?
- Signed and dated the Access Request Form?
- Included a cheque or postal money order for €6.35 made payable to GeoDirectory?
If you have ticked No to any of these questions, we regret that we cannot process your request.
Please return this completed form and associated documents to:
Data Protection Coordinator
GeoDirectory
3A GPO
O’Connell Street
Dublin 1
Note: we require proof of the applicant’s identity and address to ensure that the person making this access request is acting legitimately.
Office use only
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