Data protection act: Application for CCTV data access

Section

Address: *

Is the data subject (the person whose image is recorded) the person who is making the application? *

Yes

No

Full Name of Data Subject: *

Address of Data Subject: *

Is it possible to obtain the signature of the data subject? *

Yes

No

Data Subject Signature: *

Date:

Please state your reasons for why it is not possible to obtain the signature of the data subject: *

Please state your reasons for requesting the image: *

Date on which the requested image was taken: *

Please use this format: DD/MM/YYYY

Time at which the requested image was taken: *

Location of the data subject at time image was taken (i.e. which camera or cameras): *

Full description of the individual, or alternatively, attach to this application a range of photographs to enable the data subject to be identified by the operator: *

If you are attaching images instead, please state.

You can attach a range of photographs of the data subject to enable them to be identified by the operator below:

Maximum upload size: 67.11MB

Please indicate whether you (the applicant) will be satisfied by viewing the image only: *

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Data protection act: Application for CCTV data access

Section