Data Subject Withdrawal Form

Page 1

Storm Technologies Limited

Policy Title:

Data Subject Withdrawal Form

Policy No:

018

Version:

1.01

Effective Date:

16/03/18

Reviewed:

January 2020

Owner:

Data Protection Officer

1.1

I, [data subject name], withdraw my consent to process my personal data from Organisation Name. Organisation Name no longer has my consent to process my personal data for the purpose of [specify legitimate reason of processing personal data], which was previously granted.

Signed by data subject:

Date: Request actioned: Data Protection Officer / GDPR Owner

Date:

The Data Protection Officer is the owner of this document and is responsible for ensuring that this procedure is reviewed in line with the review requirements of the EU GDPR. A current version of this document is available to all members of staff on the company Intranet. This work instruction was approved by the Data Protection Officer / GDPR Owner on [date] and is issued on a version controlled basis under his/her signature

Signature:

March 2018 ST018_v1

Date:


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