GDPR Data Subject Rights Form
Epiq is fully committed to protecting the privacy and security of all data entrusted to us by our customers, employees and others. In accordance with European and other related national laws you may have the right to, among other things, request access to personal information about you that Epiq maintains. We ask that you complete this form so that we have a record of your request and can respond promptly.
Thank you for your help!
Section 1: Your Details
First Name
*
Last Name
*
Phone Number
*
Email Address
*
Country of Residence
*
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo {Democratic Rep}
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland {Republic}
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar, {Burma}
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Address of Residence
*
Section 2: Relationship with Epiq
Relationship with Data Subject
*
Required to select one of the following:
Employee
Former Employee
Job Applicant
Marketing Subscriber
Customer
Section 3: Proof of Identity
Please provide a proof of residence by attaching one of the following:
• Your bank or credit card statement (You must send a photo/scan of a physical letter or PDF copy of your statement)
• Your utility bill - Gas, Electric, Phone (We cannot accept mobile phone bills)
• Your council tax bill, or a HMRC notification
• Your vehicle registration or tax
• Your photo driving licence showing your address and its expiry date
• Other government or financial institution issued document
To ensure we are releasing data to the right person we require you to provide us with proof of your identity. Please supply us with the following:
• Photocopy or scanned image of current Passport
OR
• Driver’s License
Requirements for validation documents
Attach appropriate documents for Address Verification
Attach image of passport or driver's license to satisfy the need to validate Proof of Identity
We reserve the right to request additional information to authenticate your identity if we determine necessary.
Section 4: What Information Are you Seeking?
What type of request are you making?
Request Type
*
Erase My Data
Access My Data (Access or Portability)
Correct My Data (Rectification)
Object To Processing
Restrict Processing
Other
Request Description
*
Please describe the information you are seeking and include any relevant details you think will help us to identify the information you require.
Please note that if the information you request reveals details directly or indirectly about another person we will have to seek the consent of that person before we can let you see that information. In certain circumstances, where disclosure would adversely affect the rights and freedoms of others, we may not be able to disclose the information to you, in which case you will be informed promptly and given full reasons for that decision.
While in most cases we will be happy to provide you with copies of the information you request, we nevertheless reserve the right, in accordance with Article 14 of the GDPR, not to provide you with copies of information requested if doing so would take “disproportionate effort”, or in accordance with Article 12 of the GDPR to charge a fee or refuse the request if it is considered to be “manifestly unfounded or excessive”. However, we will make every effort to provide you with a satisfactory form of access or summary of information if suitable.
We will make every reasonable effort to provide the information you request within one month of receipt and will inform you if we need more time to respond.
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