Subject Access Request CCTV form

Request to access CCTV footage

Section 1: Who is this request for?

First name *

Last name *

Address line 1 *

Address line 2

City *

County *

Postcode

Email address *

Confirm email address *

Information to enable us to deal with your request

So that we can identify you from the CCTV footage, please answer the questions below and provide as much detail as possible. We will not undertake a search unless you can provide sufficient information that will allow us to find the footage and identify you.

Describe the personal information you require access to *

Location of the CCTV camera *

Date and time the camera would have recorded you (please estimate) *

Please provide either a photograph or a description of yourself and the clothing you were wearing on the day *

If known, please provide the name of any Peabody employee you have been dealing with in connection with this matter *

Supporting media

Please tick the box to declare that the information given is true and accurate. *

Please tick the box to declare that the information given is true and accurate.

I understand that Peabody has one month to respond from the date I provide all information requested *

I understand that Peabody has one month to respond from the date I provide all information requested

I have provided the following required information (please tick all that apply): *

Name and address

Two forms of identification

Letter of authority (if applicable)

Date *

Section 4: Further details

Are you a Peabody colleague completing this form on the customer's behalf? *

Yes

Is this a verbal request? *

Yes

Completed by (staff name) *

Job title *

Data protection

We take our data protection responsibilities seriously and collect, store and process data in line with data protection law. To find out more about how we use your personal information please visit our privacy policy statement.

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