FORM: POPIA ACCESS REQUEST
The Protection of Personal Information Act, POPIA, gives individuals the right to ask our organisation to confirm that we are processing your personal information and provide you with a copy of that personal information.
Personal information can be any information identifiable to a particular person. For example: name, contact details, email, race, health statues, etc.
- Access Request - If you want to more than just confirm whether or not we hold your personal information, it will help us process your request more easily if you are able to provide additional information below such as:
- Full particulars of the record to which access is requested, including the reference number if that is known to you
- If you qualify for exemption of the payment of any fee in respect of your request, please state the reason for exemption
- If the record is in written or printed form, whether you want a copy of the record or wish to inspect the record
- If the record consists of visual images, whether you want to view the images, a copy of the images or a transcription of the images
- If the record is held on computer or in an electronic or machine-readable form, whether you want a printed copy of the record, a printed copy of information derived from the record or a copy in computer-readable form
- If the record consists of recorded words or information which can be reproduced in sound, whether you want to listen to the soundtrack or want a transcription of the soundtrack
- If you requested a copy or transcription of a record, indicate if you wish the copy or transcription to be posted to you and also note that postage will be payable.
- Indicate whether a disability requires you to access the record in some other format.
- Select the relevant request type, complete the details and 'Submit' it to us via email on email@example.com:
- Objection: In terms of Section 11(1), (d to f) of the Protection of Personal Information Act, I would like to raise an objection to the processing of my personal information. Please find all the necessary details below.
- Correction: I would like to make corrections to or delete certain of my personal information which is in your possession or under your control. Please find below, details of the personal information that must be corrected or deleted as well as the reasons why this request is being made.
- Deletion Request: I would like to delete certain RECORDS of my personal information which is in your possession or under your control and that you are no longer authorised to retain. Please find below, details of the RECORDS that must be deleted as well as the reasons why this request is being made.
- NOTE: - The official Form C from the Regulator's website, complete it and email it to us (Available on request).
Particulars of the person making the request:
First name: ________________________________________________________________________________
Last name: ________________________________________________________________________________
Email address: _____________________________________________________________________________
Postal address: _____________________________________________________________________________
Telephone number: _________________________________________________________________________
Fax number: _______________________________________________________________________________
Person's relationship with our organisation:
Employees / Prospective Employees / Clients / Contracting Staff / Service Provider / Other (Specify)
Are you applying on behalf of another person? ___________________________________________________
How would you prefer our response and any information to be presented to you?
Orally / In Writing / Via EMail / Other (Specify)
Name & Surname: ______________________________ Signature: ________________ Date: __________