Personal Information Erasure Request Form (GDPR)

1.0 Introduction
In accordance with the General Data Protection Regulation (GDPR), you have the right to ask for certain personal information relating to you to be erased by Stroma.

This form is to be used for requesting the removal of your personal information, where you no longer have a relationship with Stroma.

When you make your request, Stroma will review this request in accordance with the General Data Protection Regulation (GDPR), and any other regulatory requirements, e.g. certification scheme membership where retention of information is required for a period of time.

We may decline to remove certain information where this is needed concerning complaint handling, professional malpractice or criminal convictions.
2.0 Personal Information
Please provide your details below so we can ensure that the correct records are obtained.
Data Subject Name Data Subject Name * Title First Last Suffix
Address Address *
Street Address Address Line 2 City County Postcode Country
Company Name (where applicable)
Certification or Reference Number (where applicable)
Contact Telephone Number *
Email Address *
3.0 Acting on Behalf of
Please confirm the status of submitting this request. If you are submitting this request on behalf of someone else, please select the appropriate option below. We may ask for documentation confirming that you are authorised to represent this person. *

Please confirm the status of submitting this request. If you are submitting this request on behalf of someone else, please select the appropriate option below. We may ask for documentation confirming that you are authorised to represent this person. Myself Family Member Friend A Client Other
If other please specify below.
3.1 Identification
To prevent fraudulent removal requests, Stroma needs to verify the identity of the person on whose behalf the request is made (the relevant individual).

A passport or other government-issued ID is not mandatory; however, suitable documentation must be provided. You may obscure parts of the document (e.g. ID number) as long as the remaining information identifies the relevant individual. You may also obscure any photograph in the identification document.

Stroma will only use this information to help us assess and document the authenticity of your request and we will then delete the documentation provided within a month of closing your removal request, except as otherwise required by law.
Please upload your identification here. *

Attach Files
4.0 Reason for Removal
Please provide details below of the information that you would like Stroma to remove.

This should include details of previous relationships with Stroma, i.e. certification scheme, former employee etc, so we can process your request as efficiently as possible. Failure to provide detailed information may result in a delay or further information being requested.
Removal Information *
Stroma will ensure compliance with the General Data Protection Regulation (GDPR) when processing the personal information that you have included within this document. Stroma will only use this information in accordance with the business relationship held, e.g. existing client or certified member, and to contact you about other opportunities with Stroma if you have given permission for this to happen. If you would like to find out more information about Stroma’s compliance with GDPR and your personal data, please visit our website www.stroma.com/data-protection. If you have any questions concerning data protection or the use of your personal data, please contact us to discuss further.
5.0 Declaration
*

I confirm that I am the named person in Section 2.0 of this form, and that I am submitting this form to request the removal of my personal details held by Stroma. Where submitting this form on behalf of another person, I can confirm that I have the authority to do so. I understand that where Stroma are unable to verify details in this form, the removal request may be delayed whilst further action is taken.

Produced By:
Mr Mark Rollins-Mann - QHSE Director

Authorised By:
Mr Ian O'Connor, Managing Director

On behalf of the Stroma Building Control

Issued Date: 26/06/2023
Issue Revision: v1.2

Personal Information Erasure Request Form (GDPR)

Personal Information Erasure Request Form (GDPR)

2.0 Personal Information Please provide your details below so we can ensure that the correct records are obtained.

3.0 Acting on Behalf of

5.0 Declaration

2.0 Personal Information
Please provide your details below so we can ensure that the correct records are obtained.