NIALL COLGAN & CO.

Solicitors

SUBJECT ACCESS REQUEST FORM

Personal information collected from you by this form, is required to enable your request to be appropriately processed, this personal information will only be used in connection with the processing of this Subject Access Request. This form is only to be used when making application for access to personal data held by Niall Colgan Solicitors & Co.

1. Details of the person requesting the Information:

• Full Name:
• Former Name(s):
• Current Address:
• Former Address (Inc. Dates of change):
• Date of Birth:
• Client reference number (if applicable):
• Contact phone number (including area code):
• E-mail address:

     2) Are you the Data Subject? (tick box that applies)

• I AM the Data Subject and enclose evidence of my identity e.g. photocopy of driving licence, birth certificate, passport, marriage certificate.
• I am NOT the Data Subject, but am acting on their behalf as their personal representative. I have written authority, which I enclose and evidence of their
• identity e.g. photocopy of driving licence, birth certificate, marriage certificate, passport.
• I am NOT the Data Subject, but I am acting on their behalf as their parent or legal guardian and enclose evidence of their identity e.g. photocopy of birth certificate, passport.

    3) Details of the Data Subject (if different to 1.)

• Full Name:
• Former Name(s):
• Current Address:
• Former Address (Inc. Dates of change):
• Date of Birth:
• Client reference number (if applicable):
• Contact phone number (including area code):
• E-mail address:

4. Describe the specific information you are requesting: please provide as much detail as possible, such as relevant dates, references etc.

5. Declaration

I declare that the information given by me is, to the best of my knowledge correct and that I am entitled to apply for access to the information referred to above, under the terms of the Data Protection Acts and the GDPR.

Signature: 

Date of Request:

Once Niall Colgan Solicitors & Co. has all the required information, and fee (where applicable), your request should be complied with within 21 days. In exceptional circumstances where it is not possible to comply within this period you will be informed of the delay and given a timescale for when your request is likely to be met.

In certain circumstances, the Data Protection Acts and the GDPR permit Niall Colgan & Co. Solicitorsto withhold information, for example information likely to cause serious harm to the physical or mental health or condition of you, or any other person. Information relating to or provided by a third person who has not consented to the disclosure, including images removed or obscured. This exemption does not apply where that third person is a health professional involved in care of a patient.

Where to send your request:

Niall Colgan &Co. Solicitors

20 South Mall

Cork City

Co. Cork, Ireland