Third Party Request for Personal Information
Southampton City Council will only disclose personal information where an exemption to GDPR principles applies
under Schedule 2 of the Data Protection Act 2018 and it is necessary and proportionate to do so.
Please send completed forms to information@southampton.gov.uk
.
Fields marked with an asterisk (*) are mandatory, and forms will be rejected unless these are complete.
Southampton City Council is collecting this information in order to process your request, and if further information is
needed in order to do so, you may be contacted using the details provided.
In processing this request, the Council may be required to share your information with other organisations or
departments, but it will only do so when it is necessary in order for the request to be processed.
More detailed information about the Council’s handling of your personal data can be found in its privacy policy,
available online (http://www.southampton.gov.uk/privacy
) or on request.
Applicant Details
First Name*
Last Name*
Employed by*
Rank and No.
Contact Tel.*
Contact Email*
Details of the Data Subject
If information is required on multiple data subjects, please a complete a separate form for each.
First Name*
Last Name*
Address
Date of Birth
Information Requested
Detail the information sought* (Please be specific as possible including the relevant timeframe)*
If this request relates to a criminal investigation what is the offence under investigation? (This is
a required field, where applicable)*
Legal Basis
The purpose for applying an exemption to GDPR principles?:*
the prevention, investigation, detection, or prosecution of criminal
offences
the assessment or collection of a tax or duty or an imposition of a
similar nature
legal proceedings (including prospective legal proceedings), or
connection with legal proceedings
the Council has a legal duty to disclose the information. (Please
specify legislation or other authority requiring disclosure)
other (please give further details below)
Other
What would be the likely prejudice to your investigation if the information is not provided to you?
(Please ensure your answer covers all the information you are requesting and the entire time
period)*
Why is it necessary and proportionate to disclose the information to you? (If this is already
answered in the section above, please confirm below)*
Informing the Data Subject
If the data subject was informed of your request would this be likely to prejudice your
investigation (or the wider purpose criminal investigation or tax purpose)?*
Yes No
Please Note - If you answer ‘No’ Southampton City Council will be obliged to tell the data
subject about information it has provided to you.
If 'Yes', please give details below*
Declaration
I declare that the information I have given on this form is correct and
complete as far as I know and believe
I will only use the information supplied by SCC for the above-stated purpose
Signed
If emailed, inclusion of the Applicant’s and Senior Officer’s email addresses will suffice as an ‘electronic
signature’, and so no signed hard copy will be needed.
Date*
Authorising Officers' Details (if applicable)
Name
Rank and No.
Contact Tel.
Contact Email
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