Dear Data Owner,
We kindly request that you submit your requests regarding your rights listed in Article 11 of the Law on Protection of Personal Data No. 6698 and reiterated in the HeartInCare Personal Data Protection and Processing Policy to our company by filling out this form in accordance with the relevant legal legislation, using any of the methods below.
Applications made to our company will be answered within 30 (thirty) days at the latest from the date the request reaches the company, depending on the nature of the request, in accordance with Article 13/2 of the KVKK.
| APPLICATION METHOD | ADDRESS FOR APPLICATION | SUBJECT OF APPLICATION |
|---|---|---|
| WRITTEN APPLICATION | ... (Company Open Address) | "Information Request Under the Law on Protection of Personal Data" will be written on the envelope/notification. |
| APPLICATION VIA E-MAIL | [email protected] | "Information Request Under the Law on Protection of Personal Data" will be written in the subject line of the e-mail. |
| NAME - SURNAME | ......................................................................................... |
| T.R. IDENTITY NO | ......................................................................................... |
| ADDRESS | ......................................................................................... |
| MOBILE PHONE | ......................................................................................... |
| E-MAIL ADDRESS | ......................................................................................... |
YOUR RELATIONSHIP WITH OUR COMPANY:
Please mark the box (X) next to the right(s) appropriate for your request:
| Selection | Subject of Request |
|---|---|
| [ ] | I want to learn whether your company processes personal data about me. |
| [ ] | If your company processes personal data about me, I request information about these data processing activities. |
| [ ] | If your company processes personal data about me, I want to learn the purpose of processing and whether they are used in accordance with the purpose of processing. |
| [ ] | If my personal data is transferred to third parties at home or abroad, I want to know these third parties. |
| [ ] | I think my personal data is incomplete or incorrectly processed and I want them to be corrected. |
| [ ] | Although my personal data has been processed in accordance with the law and other relevant legal provisions, I want my personal data to be deleted. |
| [ ] | I want my personal data, which I think is incomplete and incorrectly processed, to be corrected before the third parties to whom it is transferred. |
| [ ] | I want my personal data, which I requested to be deleted, to be deleted before the third parties to whom it is transferred. |
| [ ] | I think that my personal data processed by your company is analyzed exclusively through automated systems and that a result against me has arisen as a result of this analysis. I object to this result. |
| [ ] | OTHER (Please explain below.) |
Please explain the details regarding your request within the scope of the law:
............................................................................................................................................. ............................................................................................................................................. ............................................................................................................................................. .............................................................................................................................................
Please select the method by which we will notify you of our response to your application:
Applicant / Representative:
(Fill in this section only if you are applying on behalf of someone else)
This application is made by me as the "Representative of the Data Owner". I accept, declare and undertake that I am legally authorized to make this application, that all kinds of information and documents in the application are correct and accurate; that I have not given any illegal, wrong, misleading information.
I accept, declare and undertake that if I make an unauthorized application, I may cause the personal data obtained with my application to be shared illegally and/or unfairly; therefore, I take all kinds of responsibility, and also that I am responsible for the damages that the COMPANY may incur directly or indirectly due to this unauthorized application.
IMPORTANT NOTE: In all kinds of applications to be made by a representative on behalf of the data owner, in addition to the Application Form, a certified copy of the power of attorney approved by a notary public declaring that he/she is authorized to make the relevant application; in applications to be made by persons under custody/guardianship, the documents documenting the situation must be sent to the COMPANY. [cite_start]We would like to remind you that if the documents listed additionally are not sent or do not have the declared characteristics, the applications will not be evaluated.[cite: 190]
Person Applying on Behalf of Personal Data Owner:
* This document is for informational purposes.