Processing Restriction Request Form

Article 18 of the EU General Data Protection Regulation (Regulation (EU) 2016/679) (GDPR) grants you the right to restrict the processing of personal data.

Requestor Name (Data Subject) and Contact Information

Please provide the data subject’s information in the space provided below. If you are making this request on the data subject’s behalf, you should provide your name and contact information in Section 2.

We will only use the information you provide on this form to identify you and the personal data associated with your processing restriction request, and to respond to your request.

First and last name:

Any other names that you have been known by (including nicknames):

Home address:

Date of Birth:

Telephone Number:

Email Address:

If you are a current or former employee of LSHTM, please provide your employee identification number and your approximate dates of employment:

1. Proof of Data Subject’s Identity

Ecogenic Ltd requires proof of your identity before we can respond to your processing restriction request.

To help us establish your identity, you must provide identification that clearly shows your name, date of birth, and current address.

Ecogenic Ltd accepts a photocopy or a scanned image of one of the following as proof of identity:

passport or photo identification,
driver’s license,
national identification number card,
birth or adoption certificate.

If you have changed your name, please provide the relevant documents evidencing the change.

If you do not have any of these forms of identification available, please contact [email protected] for advice on other acceptable forms of identification.

Ecogenic Ltd may request additional information from you to help confirm your identity and your right to restrict processing.

Ecogenic Ltd reserve the right to refuse to act on your request if we are unable to identify you.

2. Requests Made on a Data Subject’s Behalf

Please complete this section of the form with your name and contact details if you are acting on the data subject’s behalf.

First and last name:

Home address:

Date of Birth:

Telephone Number:

Email Address:

Ecogenica Ltd accept a photocopy or a scanned image of one of the following as proof of your identity:

passport or photo identification,
driver’s license,
national identification number card,
birth or adoption certificate.

If you do not have any of these forms of identification available, please contact [email protected] to request advice on other acceptable forms of identification. We may request additional information from you to help confirm your identity if necessary.

We also require proof of the data subject’s identity before we can respond to the request.