Data Portability Request Form 1 – Person that the information relates to (the individual) Title: Full name: Former name by which you may be known to in the Trust’s records: Current Address (incl. postcode): Previous Address (incl. postcode): Email : Telephone number: Date of Birth: Reference numbers e.g. payroll, customer reference (If applicable): To verify the individual’s identity, we need to see two pieces of identification. Select one from list A and one from list B. One of these must be identification with a photo. Please indicate which ones you are supplying. List A List B Driving LicencePassport/Travel documentBirth Certificate Utility Bill showing current home address (no more than 3 months old)Bank Statement or Building society Book (no more than 3 months old) Please DO NOT send original copies in the post. Photocopies or scanned copies are acceptable and can be attached to this request or emailed to legal@ecogenica.co.uk 2 – Is the request for personal data related to you only? No, the information is not about me (go to part 3) Yes, the information is about me (go to part 4) 3 – Person (or agent) acting on behalf of the individual Title: Full name: Company: Current Address (incl. postcode): Email : Telephone number: What is your relationship to the individual? (e.g. parent, carer, legal representative or other): Please note that we cannot provide you with the information requested unless you provide the above details. If you are acting on behalf of the individual, you must submit their written authority such as Power of Attorney or Statutory Declaration. Photocopies or scanned copies are acceptable and can be attached to this request or emailed to legal@ecogenica.co.uk 4 – Details of personal data being requested Under Article 20, GDPR you have the right to receive a copy of certain personal data that you provided to us, or the right to transmit that personal data to another data controller, if we use automated means to process the personal data and we either: • Process the personal data with your consent. • Process the personal data because it is necessary for us to perform a contract with you Your data portability right does not apply to personal data we hold in paper files. In response to your request, we will provide you or the data controller with a copy of the personal data covered by the Article 20 data portability right in a structured, commonly used, and machine-readable format. Please explain in as much detail as possible the information you are requesting. Such as: old address, boat names and index numbers, names of previous contacts or file reference numbers can also be useful. If necessary, please continue a separate page. 5 – Cost There is normally no fee for a right to data portability. However, Ecogenica Ltd is permitted to charge a reasonable fee when a request is deemed manifestly unfounded or excessive. If it is particularly repetitive or is requesting further copies of the same information. You will be informed where it is determined that a fee is payable. Under the General Data Protection Regulation, Article 12 (5). 6 – Communication and Disclosure What is your preferred method of being contacted? EmailPostBy Other (please specify) 7 – Declaration I can confirm that the information given on this form is true. I understand that Ecogenica Ltd is obliged to confirm proof of identity/authority. Ecogenica Ltd may at any time request further information in relation to this request. Ecogenica Ltd is required to respond within 30 days of the data portability request, upon confirmation of proof of identity. Note that under the relevant law Ecogenica Ltd can refuse the data portability request. Tick this box to confirm Name: Signed: date: Any person who unlawfully obtains or attempts to obtain personal information is guilty of a criminal offence and is liable to prosecution. 8 – Check List - Ensure you have completed all sections accurately. Enclosed proof of the identity of the individual– see part 1 Enclosed proof of authority to act on behalf of the individual (if appropriate) – section 3 Given enough details for us to locate the information you seek – section 4 Completed the declaration – section 7 Completed all relevant sections of the form - (part 3 only to be completed if acting as an agent) Please submit this form and accompanying documents to legal@ecogenica.co.uk
