RPC012071_EN_WB_L_1
Designed by the Revenue Printing Centre
D D M M Y Y Y Y
Data Access Request Form
I wish to make a data access request pursuant to Article 15 of the General Data Protection
Regulation (GDPR) and / or section 91 of the Data Protection Act 2018.
Please provide me with the personal data specied below
(for example, all tax records for the years 2006-2008 or all LPT information on le):
Date:
Signature (if form is posted):
Please email this form to dataprotection@revenue.ie or post to the following address:
Data Protection Unit,
Revenue Commissioners,
Cross Blocks,
Dublin Castle,
Dublin 2, D02 F342
Revenue requires the following information so that we can verify your identity. Please ensure that
the details submitted match those that you have provided to Revenue.
Name:
* PPSN:
Address:
Eircode:
Phone Number:
Email address:
Please include a daytime telephone number so that we can contact you if we have any queries in relation to your
request or need to further verify your identity.
*Please note: While you are entitled to submit your data access request electronically, please do not send your PPSN
via standard email, as this is not a secure method of communication.
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