European Union (EU) General Data Protection Regulation (GDPR)

Data Subject Request Form

Chapter 3 of the EU GDPR provides a Data Subject or their representative, as defined in Article 4 of the GDPR, with an ability to exercise certain rights in relation to the personal information that your Site Owner (or we) processes on behalf of that Data Subject.

To exercise rights as a Data Subject under the GDPR, please complete this Data Subject Request Form. Please note that you will be asked to provide proof of your identity and your request will be processed within 30 calendar days of WorldModern ’ receipt of a fully completed form and proof of identity. Please note the next steps and directions at the end of the form. The information you supply in this form will only be used for the purposes of identifying the personal data you are requesting and responding to your request. You are not obliged to complete this form to make a request, but doing so will make it easier for us to process your request quickly.

Please note the next steps and directions (Section 7) at the end of this form.

Section 1: Details of the requestor

Full name (required):
Address (required):
Contact telephone number (required):
Email address (required):
Country of Residence (required):

Section 2: What is your relationship to the WorldModern Owner?

☐	Website User
☐	Employee
☐	Ex-Employee
☐	Ex-Website User
☐	Recipient of Marketing Material
☐	Vendor Representative
☐	Customer Representative
☐	Other (Please Specify):

Section 3: Are you the data subject?

Please tick the appropriate box and read the instructions that follow it.

☐

YES: I am the Data Subject. I have enclosed proof of my identity*, as outlined below. (Please go to section 5)

☐

NO: I am acting on behalf of the Data Subject. I have enclosed proof of my identity, proof of the Data Subject's identity* and approval from the data subject to make the request on their behalf.

(Please go to section 4)

*Proof of identity:

To ensure we are releasing data to the right person we require you to provide us with proof of (1) your identity and (2) your address. Acceptable forms of proof include:

1) Proof of Identity: passport, photo driving license, national identity card

2) Proof of Address: utility bill, first page (with address) of bank statement, credit card statement (no more than 3 months old), current driving license.

Note: If we are uncertain that you are who you claim to be, we reserve the right to refuse to grant your request.

Section 4: Details of the data subject (if different from section 1)

Full name (required):
Address (required):
Contact telephone number (required):
Email address (required):
Country of Residence (required):

SECTION 5: Please detail your request below.

Please provide any relevant details you think will help us.

SECTION 6: Directions, notes and next steps

1. Please print, complete, sign and scan this form. Email the form to support@worldmodern.com, or use the Contact Site Owner button on the Help Page of your website. We cannot guarantee receipt by any other method.

2. If the information you request reveals details directly or indirectly about another person, we will have to seek the consent of that person before we can let you see that information.

3. In certain circumstances, we may deny your request, or may not be able to disclose information to you, in which case you will be informed promptly and given reasons for that decision.

4. While in most cases we will be happy to provide you with copies of the information you request, we nevertheless reserve the right, in accordance with Article 12 of the GDPR, to charge a fee or refuse the request if it is considered to be “manifestly unfounded or excessive.” However, we will make every effort to provide you with a satisfactory form of access or summary of information if suitable.

5. The information provided will be used for processing Data Subject requests. The provision of personal data is voluntary. However, if you do not provide sufficient information, we cannot process your request.

6. If the request is made by an individual other than the Data Subject, an authorization letter signed by the Data Subject and information that can provide proof of the identity of the Data Subject and further proof of the Requestor’s status as a relevant person should be enclosed.

7. You may be asked to provide additional information to help us process your request.

SECTION 7: Declaration

Please note that any attempt to mislead may result in prosecution.

I confirm that I have read and understood the terms of this Data Subject Request Form and I certify that the information given in this application to your Site Owner is true. I understand that it is necessary for my Site Owner to confirm my and / or the data subject’s identity and it may be necessary to obtain more detailed information in order to locate the correct personal data.

Signed Date

Thank you,

WorldModern

modernlifestyle@worldmodern.com