Data Subject Application Form
ÜNLÜ AKADEMİ DENTAL POLYCLINIC JOINT STOCK COMPANY
DATA SUBJECT APPLICATION FORM
1. Application Method
Within the scope of your rights listed in Article 11 of the Law No. 6698 on the Protection of Personal Data (“Law”), you may submit your requests to our Company by using this form and one of the methods explained below, pursuant to Article 13 of the Law and Article 5 of the Communiqué on the Procedures and Principles of Application to the Data Controller.
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APPLICATION METHOD |
ADDRESS TO APPLY ADDRESS |
INFORMATION TO BE STATED IN APPLICATION |
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1- Written application
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Application in person with wet signature or via Notary Public
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SIRAKAPILAR NEIGHBORHOOD, 506 STREET NO:12 Merkezefendi/DENİZLİ |
“Request for Information Within the Scope of the Law on the Protection of Personal Data” shall be written on the envelope/notification.
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2. Application via Registered E-mail Address in Our System
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By using your e-mail address registered in our Company’s system
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info@unluakademi.com |
The subject line of the e-mail shall state: “Request for Information Under the Law on the Protection of Personal Data”
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Your applications submitted to us will be answered within thirty (30) days from the date they are received by us, depending on the nature of the request, pursuant to paragraph 2 of Article 13 of the Law. Our responses will be delivered to you in writing or electronically in accordance with Article 13 of the Law.
2. Identity and Contact Information
Please fill in the fields below so that we can contact you and verify your identity. The personal data requested within the scope of this form are collected solely for the purpose of evaluating and finalizing your application and contacting you, and are not processed for any other purposes.
Name Surname |
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Turkish ID Number / For Foreign Nationals: Passport Number or Identification Number: |
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Residential Address for Notification / Workplace:
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Phone Number:
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Fax Number:
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E-mail Address:
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3. Please specify your relationship with our Company (Customer, business partner, job applicant, former employee, visitor, etc.)
☐ Customer |
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☐ Business Partner |
☐ Visitor |
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☐ Former Employee Years Worked: ………………………………………. |
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☐ Job Application / Resume Submission Date ………………………………………………………………….. |
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☐ Other: …………………………………………………………….. |
Department you were in contact with within our Company: ……………………………………………………………
Subject: ……………………………………………………………………………………………………………
4. Please specify your request under the Law in detail:
…………………………………………………………………………………………………………………
5. Please select the method by which you would like to receive our response:
☐ I want it to be sent to my address.
☐ I want it to be sent to my e-mail address.
(If you choose e-mail, we will be able to respond faster.)
☐ I want to receive it in person.
This application form has been prepared to identify your relationship with our Company and to ensure that your application is answered accurately and within the legal time period. Our Company reserves the right to request additional documents for identity verification. The Company does not accept responsibility for requests arising from incorrect or unauthorized applications.
Applicant (Personal Data Owner) Name Surname:
Application Date:
Signature: