Data Protection Act 1998

Subject Access Request

Completion of this form enables Knowsley Council to deal promptly with this request and satisfies the legal requirements placed upon it to ensure the identity of Data Subjects.

Complete in block capitals and indicate on the summary list the registered purposes you wish us to search. The fee chargeable for providing such information is currently £10.

1. Your details

Applicants full name

Address and postcode

Telephone number

2. Details of the request

Are you:

A: The data subject Yes No

B: An agent for the data subject Yes No

C: The parent of a child who is not old enough to understand a request and you are acting in the best interest of the child Yes No

If your answer to B is yes, please attach a copy of the authority to act on the data subject’s behalf and enter the name and address of the data subject in section 3 below.

3. Data subject (for use by agents of the data subject only)

Data subject’s full name

Data subject’s address and postcode

Data subject’s telephone number

4. Confirmation

I understand that it may be necessary for the authority to obtain more detailed information in order to be satisfied as to my or the data subject’s identity and to locate my or the data subject’s personal data.

I enclose a fee of £ as requested.

Signed………………………………. Date…………………

5. ForOfficial Use Only

Enquiry number:
Date received:
Identity confirmed: / By:
Authorisation check: / By:
Date extracted: / From: / System: / By:
Fee paid: / Cheque Cash / Date:
Date responded:

6. Summary list

Please tick which areas you wish us to search

  1. Staff administration
  2. Advertising, marketing and public relations
  3. Accounts and records
  4. Property management
  5. Leisure and cultural services
  6. Education
  7. Assessment and collection of taxes and other revenue
  8. Benefits, grants and loan administration
  9. Planning, licensing, registration and regulation
  10. Social services
  11. Crime prevention and prosecution of offenders
  12. Corporate functions
  13. Other non commercial services
  14. Other commercial services

Registration number Z5775143