Right of Access Request Form

Right of Access Request Form

The University will use the details given on this form and against the proof of identify and information held in our recordkeeping systems to help ensure that we only release your information to legitimate persons and prevent a data breach.
Title
Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Email (providing a Leeds Beckett assigned email address is adequate for proving your identity)
example@leedsbeckett.ac.uk
Phone Number
Correspondence Address (unless specified otherwise, the university will use your email address for communicating your information request)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student ID or staff payroll number (if applicable)
Information held on the University systems

Location of data
User this section to specify your place of work/study and other relevant Schools/Services/People where you would like the search for personal information to focus. If it relates to your personal details in relation to a particular course or module, please give details.
Categories of data
Marking a category will mean that information held of this activity will be extracted from a central recordkeeping system(s). Please add ‘Y’ against any relevant category.

Student fileStaff filePersonal financial information (Payroll, Bursaries, Grants, Loans, Pensions)Health and/or occupational health fileCCTV *The university records retention for CCTV is to destroy records within 30 days from date captured.
Description of personal information being requested
Description to indicate:
- Nature of information (e.g, Assessment, Awards, Enquiry, Complaint, Accommodation, Finance, Research, Pay, Health etc.)
- Type of Personal Information (name, address, date of birth etc.)
- Mediums/Formats (for example; data in systems, emails, minutes, reports etc.)
Time period your request relates to

To help the university provide the right information efficiently please indicate the relevant time period.
Start Date

DayMonthYear
Date
End Date

DayMonthYear
Date
Proof of identity
If you are member of staff or student and have requested this information using your Leeds Beckett.ac.uk email address, additional proof of identification does not need to be provided.

For all other requests we need to establish your identity, this is to mitigate against a data breach. Your application must be accompanied by ONE piece of valid identification; this includes a copy of your; driving licence, passport, visa, national identify card or correspondence from a Government department.

Please send a copy of your identification to infocompliance@leedsbeckett.ac.uk. The process for responding to your request for information will start from receiving your identification. Failure to provide proof of identity will delay your application.
If you wish, please upload a copy of your identification below

Cancelof
Should be Empty:

Right of Access Request Form

Information held on the University systems

Proof of identity