Templates
DSAR Template
Use this template
Data Subject Access Request Form for Example.com
Please fill out the form below. The website administrator will be notified about your request in 24 hours and will need an appropriate amount of time to respond.
Enter your contact information
Your Email
*
Name
*
What email address do you use to access the above website / app?
*
You are submitting this request as
*
You are submitting this request as
A
The person, or the parent / guardian of the person, whose name appears above.
B
An agent authorised by the consumer to make this request on their behalf.
C
Other
Under the rights of which law are you making this request?
*
I am submitting a request to ___________
*
I am submitting a request to ___________
A
Know what information is being collected from me
B
Have my personal information deleted
C
Opt out of having my data sold to third parties
D
Opt out of data processing for targeted advertising
E
Access my personal information
F
Other (please specify in the comment box below)
Please leave details regarding your action request or question.
I confirm that
*
I confirm that
Under penalty of perjury, I declare all the above information to be true and accurate.
I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with example.com
I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.
Submit