CCTV SUBJECT ACCESS REQUEST FORM

• Reference Number

DATA SUBJECT ACCESS CCTV APPLICATION FORM

• Under the terms of the Data Protection Act 1998, an individual is entitled to ask the authority for a copy of all personal information which it holds about him/her for the purpose of providing services to the individual. The information, which the individual is entitled to receive from the authority, includes a description of these purposes and recipients to whom the data can be disclosed. The entitlement is known as the "Right of Access to Personal Data". Please complete this form, providing as much information as possible, should you wish to exercise your right in requesting disclosure of your data.

• PLEASE NOTE THAT RECORDED DATA IS ONLY HELD FOR 7 DAYS BEFORE IT IS DELETED

Section 1: Personal Details

• Name

• Address

• Post Code

• Telephone Number

• Email Address

Section 2: Details of CCTV footage being requested

• TO HELP US FIND THE CCTV DATA YOU REQUIRE, PLEASE COMPLETE THE FOLLOWING SECTION: PLEASE BE AS ACCURATE AS POSSIBLE WITH TIMES, LOCATION AND IDENTIFICATION.

• Date:

  Date

• Time:

  Date

• Location of incident (area, town, street, postcode, property etc please be as precise as possible

• Description of Incident (please provide as much information as possible to identify the footage required)

Section 3: Fee & Proof of Identity

• Under the Data Protection Act 1998, we are entitled to charge an administration fee of £12.50 for processing your application.

• We also require evidence that this enquiry is genuine. Therefor please provide at least two forms of ID. Such as Passport, Driving Licence, Utility bill rtc.

• If you are applying on someone else's behalf, please provide Proof of Identity for both the Data Subject and yourself as well as documented authority to act on the Data Subjects behalf.

• FAILURE TO PROVIDE THESE DOCUMENTS WITH YOUR APPLICATION WILL MEAN THAT YOUR REQUEST IS REFUSED.

Section 4: Declaration

• I confirm that this is all of the personal data which I am requesting access and which is held by the authority for its purposes.

• I confirm that I am the Data Subject and not someone acting on his/her behalf

• Signature

  Sign

• Title

  Mr

  MX

  Mrs

  Miss

• Date

  Date

• I confirm that I am acting on behalf of the Data Subject and have submitted proof of my authority to do so

• Name

• Address

• Telephone No.

• Signature

  Sign

• Date

  Date

• Please return this form to: cctv.cole@outlook.com or Cole Baird134 Mayfield Drive, Armadale, Bathgate, EH48 2JG

• Proof of Identity

  Media