Data Subject Access Request

[1 - Your first name and surname]

[2 – Your address]
[3 – Your email address]
[4 - Date]

[5 – First and Surname of Head of the Organisation], and [the title of the office they hold], [their
email address], and
[6 – First and Surname of Data Controller], and [the title of the office they hold], [their email
address], and
[6a – First and Surname of Data Protection officer], and [the title of the office they hold], [their
email address], and
[7 - First and Surname of the Councils Monitoring Officer], and Council Monitoring Officer, [their
email address], and
[8 - First and Surname of any other people who have corresponded with you], and [their office],
[their email address], and
[9 - Council’s name and address as detailed on Summons], [their email address]

Dear [10 - Head of Council by first name], [11 - Head of Revenue by first name], [12 - Councils
Monitoring Officer by first name], [13 - any other people who have corresponded by first name]
and [14 - Name of Council],

Data Subject Access Request under Data Protection Act 2018 (“DPA2018”) and GDPR 2018

In respect of Summons referenced: [15 - summons: number], dated dd/mm/202y

Please find enclosed 2 forms of my identification, above referenced summons and [16 - add any
other form of identification (driving licence or copy of another picture ID)].

Under your organisation’s DPA2018 and GDPR 2018 legal duties and obligations, you must
respond within 1 month as specified in section 54(2). I am aware of the provisions for extra time
beyond the statutory 30-day response for complex requests. I do not believe this request to be
complex. Should you disagree, I require you to write to me stating your grounds and the time
frame you claim you need.

Under my legal rights in Part 3 Chapter 3 of, I require you to make available to me the following
information regarding data you hold about me pertaining to the information you laid (court
records) in accordance with section 51 of the Magistrates Court Act 1980 under which the above
referenced summons was granted:

Should you require any further clarification please do not hesitate to contact myself.

Regards,

[17 - Sign here]

[18 - Your first name only]

Enc: Summons and [second form of ID]

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