Right to be Forgotten Form Request for Erasure of Personal Data Under Article 17 UK GDPR 1. Requester Name (Data Subject) and Contact Information Please provide the data subject's person who is requesting their personal data be deleted 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 III. We will only use the information you provide on this form to identify you and the personal data you are requesting to erasure, 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 Ecogenica Ltd, please provide your employee identification number and your approximate dates of employment:: 2. Proof of Identity We require proof of your identity before we can respond to your access request. To help us establish your identity, you must provide identification that clearly shows your name, date of birth, and current address. If you do not have any of these forms of identification available, please contact [email protected] for advice on other acceptable forms of identification. We may request additional information from you to help confirm your identity. We reserve the right to refuse to act on your request if we are unable to identify you. 3. 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: We require proof of the data subject’s identity before we can respond to the request. To help us establish the data subject’s identity, you must provide identification that clearly shows the data subject’s name, date of birth, and current address. We accept a photocopy or a scanned image of at least one of the following: passport, driver’s license, national identification number card, or birth or adoption certificate that has a photograph attached. If you do not have any of these forms of identification available, please contact [email protected] for advice on other acceptable forms of identification. We accept a copy of the following as proof of your legal authority to act on the data subject’s behalf: a written consent signed by the data subject, or a certified copy of a Power of Attorney or Statutory declaration. We may request additional information from you to help confirm the data subject’s identity. We reserve the right to refuse to act on your request if we are unable to identify the data subject or verify your legal authority to act on the data subject’s behalf. 4. Information Requested Under Article 17 GDPR, you have the right to request the erasure of your personal data if one of the following grounds applies: The personal data is no longer necessary for the purpose we collected it for. You withdrew your consent to our processing activities and no other legal justification for processing applies. You are objecting under GDPR Article 21(1) to: processing that is necessary for us to perform a task in the public interest or in the exercise of our official authority; and there are no overriding legitimate grounds to process the personal data. You are objecting under GDPR Article 21(1) to: processing that is necessary to pursue our or a third party's legitimate interests; and there are no overriding legitimate grounds to process the personal data. You are objecting under GDPR Article 21(2) to processing for direct marketing purposes. We unlawfully processed your personal data. The law requires us to erase your personal data to comply with a legal obligation. We collected the personal data in the context of offering online services to children under GDPR Article 8(1). To help us process your request efficiently, please provide details of the personal data you are requesting to be erased. Also provide the ground or grounds you are relying on to request erasure of your personal data, according to the above. If Ecogenica Ltd made the personal data that is the subject of your erasure request public, we will take reasonable steps, including technical measures, to inform other organizations processing your personal data that you have requested erasure, including any links to, and copies of, the personal data. Ecogenica Ltd will communicate the erasure of the personal data to each recipient to whom we disclosed the personal data (for example, our third-party service providers who process the data on our behalf). However, where this request is impossible or involves disproportionate effort, we reserve the right to undertake the erasure of personal data You will be informed of the outcome of the erasure request. Applicable law may allow or require us to refuse to act on your request, or we may have destroyed, erased, or made your personal data anonymous in accordance with our record retention obligations and practices. In the event that your erasure request cannot be completed, for whatever reason, you will be promptly informed of the reasons why. Where it is determined that the personal data you are requesting to erase is not subject to Article 17 UK GDPR, you will be informed of this decision. 5.Signature and Acknowledgment I, , confirm that the information provided in this form is correct and that I am the person whose name appears on this form. I understand that Ecogenica Ltd has the right to confirm proof of identity, and that where any information has been requested, for erasure of personal data, and has not been provided within a reasonable timeframe, the request will be cancelled. If the request is cancelled the applicant may may another request and apply for the personal data to be erased. Print Name: Signature: Date: Authorized Person Signature I, , confirm that I am authorized to act on behalf of the data subject. I understand that Ecogenica Ltd must confirm my identity and my legal authority to act on the data subject's behalf, and may need to request additional verifying information. Print Name: Signature: Date:
