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*
AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe

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.

Send me a copy of my responses

Email address

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