Subject Access Form

Subject Access Request Form

Part 1 - Details of Data Subject (Person making the request)

Full Name *

Address Line 1 *

Address Line 2

City *

County

Eircode *

Contact Telephone Number *

Email Address

Part 2 - Details of Request

To assist us in identifying and locating the personal data sought, please ensure that you provide details of your interactions with the Charities Regulator, as well as any specific identifiers e.g. any previous addresses, reference numbers from previous contacts with us etc.

The details of my request are: *

The period of time for which data is sought: *

Further details:

Registered Charity Number (RCN)

Revenue CHY Number

Part 3 - Verification of Identity

The Charities Regulator must respond to your request within one month.

Part 4 - Form of Communication

I request you to forward all correspondence in relation to this request by:

Postal address provided above
Email address provided above

Part 5 - Declaration

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

Date *

Note: Subject Access Requests do not apply to deceased persons.

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 subject 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 Subject Access Request or for as long as is needed to respond to the request and implement any further requests from the data subject e.g. rectification, erasure, etc. 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

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