Data Subject Application Form
PEKER YÜZEY TASARIMLARI SANAYİ VE TİCARET ANONİM ŞİRKETİ DATA SUBJECT APPLICATION FORM
A. Application Method
Pursuant to article 13 of the Law No. 6698 on the Protection of Personal Data (the “Law”) and article 5 of the Communiqué on the Procedures and Principles of Application to the Data Controller (the “Application Communiqué”), you may submit your application regarding your request to exercise your rights which are enumerated in article 11 of the Law, by filling in this form and delivering it to Peker Yüzey Tasarımları Sanayi ve Ticaret Anonim Şirketi (the “Company”), acting in the capacity of a data controller, through the methods indicated herein below. This present application form has been prepared solely for the purposes of the easier communication of your request and the facilitation of a faster reply. The applications made otherwise, provided that they are in conformity with the procedures and principles laid down in the Application Communiqué, will also be taken into consideration and responded by the Company, in accordance with the applicable legislation.
1. Written Application
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Method of Application : Originally signed application delivered in person or via Notary Public
Address for Application : Peker Yüzey Tasarımları Sanayi ve Ticaret Anonim Şirketi Manisa - Manisa OSB IV. Kısım Keçiliköy OSB Ahmet Nazif Zorlu No:22 Yunusemre / Manisa
Heading of Application : The phrase of “Request for Information under the Law No. 6698 on the Protection of Personal Data” should be written on the envelope/notice.
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2. Application by Registered Electronic Mail (KEP)
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Method of Application : via electronic mail (KEP) address
Address for Application : [email protected]
Heading of Application : The subject of the e-mail should be written as the “Request for Information under the Law No. 6698 on the Protection of Personal Data”.
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3. Application by Electronic Mail Address Recorded in the Company’s System
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Method of Application : via you electronic mail address which is recorded in the Company’s system
Address for Application : [email protected]
Heading of Application : The subject of the e-mail should be written as the “Request for Information under the Law No. 6698 on the Protection of Personal Data”.
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4. Application by Electronic Mail Address Not Recorded in the Company’s System
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Method of Application : via your electronic mail address which is not recorded in the Company’s system, including amobile signature/secure electronic signature
Address for Application : [email protected]
Heading of Application : The subject of the e-mail should be written as the “Request for Information under the Law No. 6698 on the Protection of Personal Data”.
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B. ID Verification and Contact Details
We will be responding to your request, in writing to your contact address specified below or electronically, as per article 6 of the Application Communiqué. Accordingly, please make sure that the personal data provided below are accurate and that you are authorized to disclose such personal data.
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Details of the Data Subject
Name-Surname:
Turkish ID No. / Passport No.:
E-Mail Address / KEP Address:
Residence or Workplace Address for Notification:
Phone No. / Mobile Phone No. / Facsimile No. (voluntary):
Relation with the Company: ☐ Customer
☐ Employee
☐ Prospective Employee (Candidate)
☐ Other (Please specify below)
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The Company is responsible for verifying that the data subject filing the application is the actual right-holder or not. The Company is thus entitled to seek any and all additional verification in order to confirm your identity. In the event that a copy of your ID is communicated to the Company for ID verification purposes, please ensure that special categories of personal data (e.g. blood type or religion information) are not included in the document concerned.
C. Subject of Application
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Please clearly specify your request concerning your personal data under article 11 of the Law. Pertinent information and documents should be attached to the application.
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Please note that special categories of personal data (e.g. health information, religion information, political belief information) that are listed in an exhaustive manner under article 6 of the Law should not be included in the information or documentation which are communicated to the Company, along with your application.
D. Conclusion of the Application and Method of Notification
Your application will be concluded - free of charge - as soon as possible and within 30 (thirty) days at the latest, as of the receipt by our Company, depending on the nature of your request. However, in case the transaction requires an additional cost, you may be charged according to the tariff determined by the Personal Data Protection Board.
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☐ I want the reply to be delivered to my postal address provided in section B.
☐ I want the reply to be sent to my electronic mail address provided in section B.
☐ I want the reply to be sent to my facsimile number provided in section B.
☐ I want the reply to be sent to my KEP number provided in section B. |
I kindly ask that my application filed with your Company, along with the information, documentation and requests indicated in the application form, are evaluated pursuant to the provisions of the Law and the Application Communiqué; and that a reply is communicated to myself accordingly. In this context, I hereby declare and undertake that the information and documentation which I have submitted to your Company in this application, are correct and up-to-date; that I have been informed about the facts that my personal data may be processed by your Company for the conclusion of my application; that additional information and/or documentation may further be sought; and that if the transaction requires an additional cost, I may be charged with the fee designated by the Personal Data Protection Board.
Applicant’s Name-Surname:
Date of Application:
Signature: