This form must be signed by you (the data subject) or your agent (if applicable).
I confirm that the information I have supplied is correct and that I am the person to whom it
Data Subject Signature Date
Please ensure you enclose with your signed form:
Evidence of your identity
I confirm that I am authorised to act on behalf of the data subject and that their personal
information will be disclosed to them through me.
Agent’s name and signature Date
Please ensure you enclose with the signed form:
Evidence of the identity of the data subject
Evidence of your authority to act on their behalf
Please return this form (together with evidence of identity and if applicable agent’s
authority to act) to our Data Protection Officer, Office of the Police and Crime
Commissioner, St George's Chambers, St George's Street, Winchester, Hampshire, SO23
8AJ. Telephone number: 01962 871595. Email:
• If you require more than one copy of the data, we may charge a reasonable fee for
• If your request involves additional costs we may charge a reasonable fee.
• If your request is excessive we may charge a reasonable fee or refuse to provide
you with a copy of the data.
• Please note there is a separate application form for CCTV images.
The Police and Crime Commissioner collects the above information about you in order to
carry out your request for access to any of your personal information that we may hold.
This is so that we can comply with our legal obligation to meet your data subject rights
under the GDPR and the DPA 2018.
For more information on your data subject rights please see our General Privacy Notice: