FOI Access Request Form

Freedom of Information Request Form

Details of Applicant

Full Name *

Address Line 1 *

Address Line 2

City *

County

Eircode *

Contact Telephone Number *

Email Address

Details of Request

In accordance with Section 12 of the Freedom of Information Act 2014, I request access to records which are *

Please tick as appropriate

Non-Personal
Personal

If you are requesting personal information, please state precisely in whose name those records are held. You will not normally be given access to personal information of another person unless we are satisfied that you have obtained the written consent of that person. You may be required to provide proof of identification (current passport or driving licence, together with a recent utility bill or Government-issued letter) before personal information will be released.

I request the following records: *

In the space provided below, please describe the records as fully as you can.

The period of time for which data is sought: *

Please indicate the timeframe for your request (e.g. July 2017 or January 2018 - April 2018)

Further details:

Please provide any extra information you have which may assist us in responding to your request, e.g. any other names a charity may be known by or a link to the CharitiesRegulator.ie website.

Registered Charity Number

If your request relates to a registered charity, please enter the Registered Charity Number here.

Revenue CHY Number

If your request relates to a registered Charity, and they have a Revenue CHY Number, please enter it here.

Form of Communication

I request that you forward all correspondence in relation to this request to the: *

Postal Address provided above
Email Address provided above

Declaration

I declare that all the details I have provided in this form are true and complete to the best of my knowledge. *

Date *

Privacy Notice

The Data Protection Officer in the Charities Regulator collects the data you provide in this form. The data controller for the information you provide is the Charities Regulator. The data controller’s contact details are: The Data Protection Officer, Charities Regulator, 3 George’s Dock, IFSC, Dublin 1, D01 X5X0 Email: DPA@charitiesregulator.ie Telephone: +353-1-6331500

1. The Charities Regulator may use the personal data you provide in this form for the purpose of responding to your Freedom of Information access request.

2. Our legal basis for collecting and processing this data is the 2016/679 General Data Protection Regulation (GDPR).

3. The personal data provided here will be stored securely electronically.

4. The contact for any queries in relation to this form is the Data Protection Officer; email: DPA@charitiesregulator.ie

5. This data will be stored for 5 years from the date of the Freedom of Information Access Request or for as long as is needed to respond to the request and implement any further requests, whichever is later.

6. You have the right to rectify any inaccuracies in your data. To do this you should write to the Data Protection Officer at the address listed above documenting the inaccuracies which need to be rectified.

7. You have the right, where appropriate, to obtain erasure of your data and/or a restriction on processing of your data as well as the right to object to the processing of your data. In addition, you have the right to lodge a complaint with the Data Protection Commission. Further details in relation to your data protection rights can be found in the Charities Regulator's Data Protection statement located at https://www.charitiesregulator.ie/en/data-protection