Subject Access Request Form
(Data Protection Act 1998)
If you would like to make a subject access request under the Data Protection Act 1998,
please complete and return this form.
In order for us to process the request you must provide us with a copy
of a suitable form of
identification. This is a legal requirement to ensure that we do not inadvertently release
your records to a third party.
The ID requirement can be satisfied by a copy of one
of the following:
passport
driver’s license
Council Tax bill
recent utility bill.
Only one form of ID is required and it should be a copy rather than the original document.
There is a charge of £10 for processing subject access requests. If you are in receipt of
benefits you can request that the fee be waived (please provide a copy of evidence
demonstrating you receive benefits).
You can pay online a
t www.brighton-hove.gov.uk/pay Go to “pay online with a card” and
then choose “Data Protection Requests”
You can also pay by cheque or money order, payable to Brighton & Hove City Council.
Please note that we cannot accept cash payments
.
Upon receipt of your proof of identification, payment and full details of the information you
are requesting, we have 40 calendar days to respond to your request.
Personal Information (so that we can correctly identify your records)
Full Name
Date of Birth
Current Address
Email Address
Telephone Number
Which department or departments do you require your personal information
from? (Please tick beside each one you require).
Adult Social Care (including Community Care)
Children Services (including School Support, Youth Support, Early Years,
Quality & Performance)
Environment (including City Planning, Cityclean, Public Safety, Transport)
Finance & Resources (including Revenues, Benefits, Property & Design,
Financial Services, ICT, Human Resources)
Housing - Council/Tenancy (including tenancy services, tenancy
management, neighbourhood/estate teams)
Housing - Private Sector (including Inspection, advice, enforcement arising
from conditions in private resident accommodation and Housing Association)
Housing - Temporary (including Housing Needs, emergency
accommodation, Housing Options, Homelessness)
Other - Any information held by any department not itemised above
Please tell us what information you wish to access – it is important to be specific
and detailed in your request (i.e. by including a date or range of dates; specific people
or departments within the council; any reference numbers given to you)
I request access to….
From year
To year
What year/s of information do
you wish to access?
Any other information that will help us find personal information about you?
(For example previous name/s or addresses, reference numbers, other relevant
dates)
Signed
Date
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Brighton & Hove City Council is the Data Controller for the purposes of the
Data Protection Act 1998. This means that Brighton & Hove City Council is
responsible for making decisions about how your personal data will be
processed and how it may be used.
The purpose for which your data will be processed is respond to your request
for access to your personal data held by the Council. The information you
provide will be treated confidentially at all times.
Security safeguards apply to both manual and computerised held data, and
only relevant staff/named disclosures can access your information.
Sending your request by email Please attach:
this form
scanned copy of identification
your payment reference (if you have already paid online)
Send to
: xxxx.xxxxxxxxxx@xxxxxxxxxxxxx.xxx.xx Sending your request by post
Please return:
this form
a copy of your identification
£10 fee (or payment reference if you have already paid online)
Send to:
Information Governance Team
Brighton & Hove City Council
4th Floor, Bartholomew House
Bartholomew Square
Brighton BN1 1JE
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