Subject Access Request form

Section 1: Who is this request for?

First name *

Last name *

Date of birth *

Address line 1 *

Address line 2

City *

County *

Postcode

Email address *

Tenancy ref (if known)

Representative details

Should data be sent to a representative? *

Yes

Based on your last answer, please go straight to Section 3

Representative full name *

Please confirm permission *

I (the representative) confirm I have permission from the person in Section 1 and will attach their written authority with submitting this form

I (the person in Section 1) confirm I have obtained permission from my Representative to provide their details to you

Representative address (including postcode) *

Representative email address *

Information

Give details of any specific personal data required and any relevant dates *

Please send a copy of the requested personal data to: *

Myself

My representative

Please tick the relevant categories that apply to the personal data *

Tenancy or leasehold file

Anti-social behaviour

Complaints

Care/ support file

Repairs report data

Rent/ service charge data

Other

Please specify details (including dates and references if known) of the categories you've selected above *

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 it is an offence under section 170 of the Data Protection Act 2018 to give false information to unlawfully obtain personal data to which I am not entitled to. *

I understand that it is an offence under section 170 of the Data Protection Act 2018 to give false information to unlawfully obtain personal data to which I am not entitled to.

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.