REQUEST FOR ACCESS TO PERSONAL INFORMATION

REQUEST FOR ACCESS TO PERSONAL INFORMATION

Under the Privacy Act 2020
There are two options for requesting personal information:

Option 1: Via this portal.

Use this portal:
1. if you are requesting your own information; OR
2. you are acting as a representative for a person and are requesting on their behalf (with their permission)
Option 2: Via a Support Worker or Volunteer.
1. Advise your Support Worker or Volunteer that you want to make a request for personal information.
2. Your Support Worker/Volunteer will then work through this form with you and verify that they they have sighted your identification and are satisfied as to your identity.
3. If you are a person's representative, you can also work through this form with an Support Worker/Volunteer, but you will require further documentation as detailed below
Note: if you do not have an email address you will need to apply via a Support Worker or Volunteer

Personal Details

Victim Support requires some personal details to process your request:
• Victim Support needs to be satisfied as to your identity
• To deliver a response to your request and / or clarify your request, we require an email address or postal address and a telephone number.

Evidence of Identity

Where you are requesting your own information -

We are required under the Privacy Act 2020 to be satisfied that we know who you are. You will need to provide the following:
- Copies of TWO forms of ID (one must be photographic)
  OR
- a photograph of you holding your photographic ID.
Where you are requesting personal information as a representative -

You will need to provide the following:
- Copies of TWO forms of ID of the person about whom you are requesting the information (one must be photographic); OR
- a photograph of that person holding their photographic ID. (Name, and document number must be clearly legible in the photographic ID.)
AND
- Copies of TWO forms of your own ID (one must be photographic)
AND
- You will need to provide written authority from the person whose information is being requested that you are authorised to do this on their behalf.
Who is submitting this request?*

I am requesting information about myselfI am representing another person and requesting information on their behalfI am a Support Worker or Volunteer assisting a person to request their personal informationI am a Support Worker or Volunteer assisting a representative of a person requesting their personal information.

Details of Support Worker or Volunteer
Details of Support Worker or Volunteer
First Name*
Last Name*
Email*
example@example.com
Phone Number*

Area CodePhone Number
District*
District Managers Name*

First NameLast Name

Personal Details - of the person about whom information is requested
Personal Details - of the person about whom information is requested
First Name:*
Middle Name(s):
Last Name:*
Date of Birth (optional):

DayMonthYear
Phone Number*

Area CodePhone Number
Email Address:*
example@example.com
Alternative Phone Number

Area CodePhone Number
Address:*
Post Code:*
Address

Street Address

Street Address Line 2

City / TownRegion

Post Code

Proof of Identification - of representative
Proof of Identification - of Representative requesting information on another person's behalf
Primary Identification (including photograph):*

Drivers' LicencePassport
*Other does not include the items listed as Secondary Identification
Upload digital copy of Primary Identification:*

Accepted file types: pdf, doc, docx, jpg, jpeg, png
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Secondary Identification:*

Community Services cardSuperGold cardStudent IDBirth CertificateNZ Utilities Bill addressed to you not less than 6 months earlierOther
Upload digital copy of Secondary Identification:*

Accepted file types: pdf, doc, docx, jpg, jpeg, png
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Copy of Authorization to request information on another person's behalf:*

Accepted file types: pdf, doc, docx, jpg, jpeg, png
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Authorization document must include full name of BOTH the Representative AND the person about whom the information is requested. The document must be signed by both parties. The letter must clearly state that the person about whom information is requested gives the Representative the authority to request personal information from Maanaki Tāngata Victim Support on their behalf.