FORM 2
REQUEST FOR CORRECTION OR DELETION OF PERSONAL INFORMATION OR DESTROYING OR DELETION OF RECORD OF PERSONAL INFORMATION IN TERMS OF SECTION 24(1) OF THE PROTECTION OF PERSONAL INFORMATION ACT, 2013 (ACT NO.4 OF 2013) REGULATIONS RELATING TO THE PROTECTION OF PERSONAL INFORMATION, 2017 [Regulation 3(2)] Note: 1. Affidavits or other documentary evidence in support of the request must be attached.
Details of Data Subject
Surname:
Full Names:
South African ID Number:
Telephone:
Fax:
Cellular:
Email:
Details of Responsible Party
Natural Person
Not a Natural Person
Name and Surname:
Residential/Postal/Business Address:
Telephone:
Fax:
Cellular:
Email:
Name of Public/Private Body:
Business Address:
Telephone:
Fax:
Cellular:
Email:
Request Type
Correction
Deletion
Reason / Details:
Supporting Documents
Signature
Signed at:
Date:
Upload Signature Image: