DATA PROTECTION ACT, 2020 - NOTICE TO PREVENT PROCESSING

1. First Name of Data Subject: *

2. Middle Name of Data Subject: *

3. Last Name of Data Subject: *

4. Is the Applicant different from Data Subject? *

4 a). First Name of Applicant: *

(If different from data subject)

4 b). Middle Name of Applicant: *

(If different from data subject)

4 c). Last Name of Applicant: *

(If different from data subject)

5. Date of Birth: *

Month

Day

Year

6. TRN: *

7. Gender: *

8. Home Address: *

(Please indicate the address to which correspondence related to your application should be sent).

9. Mailing Address:

10. Telephone No.: *

11. Email Address: *

12. Confirm Email Address: *

13. I hereby direct you: *

(Please check the relevant box)

13 a). Select date: *

Month

Day

Year

To cease processing the personal data.

13 a). Specify the Purpose: *

To cease processing the personal data

13 a). Specify the Manner: *

To cease processing the personal data

13 b). Select date: *

Month

Day

Year

To cease processing the personal data.

14. The data controller is required to give effect to the direction above on the basis that: *

The processing of the personal data/the processing of the personal data for the specified purpose/the processing of the personal data in the specified manner, is causing/is likely to cause substantial damage or substantial distress to me/the data subject/to another, and that the damage or distress caused/likely to be caused is unwarranted.

The personal data is incomplete/irrelevant having regard to the purpose of the processing.

The processing of the personal data/ the processing of the personal data for the specified purpose/in the specified manner, is prohibited under the following law

The personal data has been retained by the data controller for longer than the period of time for which it may be retainedby the data controller under the following law

(Please check the relevant box)

14 a). State Law: *

15. Please submit any documents/evidence in support of the application:

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.

Disclaimer

Your data is being processed to facilitate this Data Subject Rights Request. Please note that before processing your request, we may need to verify your identity to ensure that we are disclosing personal data to the correct individual. This may involve requesting additional information from you or asking you to provide proof of your identity. Your data provided in this form will be stored securely on JCA systems for as long as is required to respond to your request and to execute any further requests from you. We will make every effort to respond to your data subject rights request in a timely manner and within the timeframe specified by applicable data protection laws. By submitting this form, you agree to the JCA’s processing of your data.