1. Information About the Data Subject
Please provide the information requested below so that we may contact you and verify your identity.
(If you are submitting an application on behalf of another person, please state your relationship with the applicant and your own identification details in the ‘Explanations’ section, and submit a copy of the notarized power of attorney authorizing you to act on their behalf. If you are applying on behalf of a minor or a person under guardianship, please submit a population registry record or relevant document showing your relationship and/or authority for verification purposes.)
Full Name: ___________________________
Turkish ID Number / For Foreign Nationals: Nationality and Passport Number or ID Number (if any): ___________________________
Residential Address for Notification / Business Address: ___________________________
Phone Number: ___________________________
Fax Number: ___________________________
Email Address: ___________________________
Please mark the option below that best describes your relationship with GENVERA.
| (.......................................................................................................) | ||
2. Information Regarding the Data Subject’s Request
Please mark your request(s) regarding personal data from the list below.
| I would like to know whether my personal data is being processed. | |
| If my personal data has been processed, I would like to request information regarding such processing. | |
| I would like to learn the purpose of processing my personal data and whether it is used in accordance with that purpose. | |
| I would like to know the third parties to whom my personal data has been transferred domestically or internationally. | |
| If my personal data has been processed incompletely or inaccurately, I request its correction. | |
| If the reasons requiring the processing of my personal data no longer exist, I request its deletion or destruction. | |
| I request that any correction made be notified to third parties to whom my personal data has been transferred. | |
| I request that any deletion be notified to third parties to whom my personal data has been transferred. | |
| I believe my personal data has been analyzed exclusively through automated systems and that this has resulted in a negative outcome for me, and I object to this result. | |
| I request compensation for damages arising from the unlawful processing of my personal data. |
Explanations:
If you believe that additional details and supporting documents are required regarding your request based on the selections made above, please provide a detailed explanation below and attach relevant documents to this form.
3. Information Regarding the Finalization of the Application
GENVERA will finalize your application as soon as possible and within a maximum of 30 days. A response will be provided through the notification method you select, based on the address, email, or fax information provided in the “1. INFORMATION ABOUT THE DATA SUBJECT” section.
Based on your application, your relationship with GENVERA will be identified, and if any personal data is processed by GENVERA, it will be determined in full. Your request will be responded to accurately, within the legal timeframe, and free of charge. If the process requires an additional cost, a fee may be charged in accordance with the tariff determined by the Personal Data Protection Board.
In order to eliminate legal risks arising from unlawful or unauthorized data sharing and to ensure the security of your personal data, GENVERA reserves the right to request additional documents and information (such as a copy of an ID card or driver’s license) for identity and authorization verification. If the information provided in your request is inaccurate, outdated, or submitted by an unauthorized person intentionally or due to gross negligence, GENVERA shall not be held responsible for such requests.
DECLARATION
In line with the requests I have specified, I kindly request that my application to your Company be evaluated pursuant to Article 13 of Law No. 6698 and that I be informed accordingly. I hereby declare and undertake that the information and documents I have provided in this application are accurate and up to date, that your Company may request additional information in order to finalize my application, and that if the process incurs an additional cost, I have been informed that I will pay the fee determined by the Personal Data Protection Board.
Preferred method of response to my application:
| I would like the response to be sent to my mailing address. | |
| I would like the response to be sent to my email address. | |
| I would like the response to be sent to my fax number. |
Full Name of Data Subject:
Signature:
Application Date:
| I HAVE READ AND UNDERSTOOD THE PERSONAL DATA PROTECTION AND PROCESSING INFORMATION NOTICE BEFORE COMPLETING THIS FORM. |
* If the response to the application is provided in writing, no fee will be charged for up to 10 pages. For each page exceeding 10 pages, a processing fee may be charged in accordance with Article 7 of the Communiqué on the Principles and Procedures for Application to the Data Controller. If the response is provided on a recording medium such as CD or flash drive, a fee equivalent to the cost of the recording medium may be requested.
