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Part VIII: Further Information and Payment

I understand that before complying with this request, you may require me to provide

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:

(a) proof of my identity;

(b) proof of the Data Subject’s identity if I am making this request as a relevant person and further

proof of my status as a relevant person;

(c) such further information as may be reasonably required for you to locate the Requested Data;

(d) payment of a fee charged under section 28 of the PDPO

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.

Part IX:

Use of Personal Data

Except with the prescribed consent of the individual concerned, the personal data provided in this Form

will be used for the purpose of processing this data access request and other directly related purposes

only.

___________________________

___________________________________________

Date

Signature of the Requestor

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Failure to provide the information as required by the Data User under this Part may result in the data access request being refused,

or not being complied with to the desired extent.

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Sections 28(2) and (3) of the PDPO provide that a fee may be charged for complying with a data access request made under section

18(1)(a) or (b), which fee shall not be excessive. According to section 28(5) of the PDPO, compliance with a data access request

may be refused unless and until any such fee has been paid.

Form OPS003 (revised 09/2012)