Request Access to Your Personal Data

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1. Your Details

Full name

Previous name or alternative name, if relevant

Telephone Number

Address

Street Address Address Line 2 City County Postal Code Country

Preferred method of contact

Chosen method of contact

2. Are You Making This Request For Yourself?

Who is this request being made for

Yes, I am making this request for myself

No, I am making this request on behalf of someone else

Requester Details

Full name

Previous name or alternative name, if relevant

Telephone Number

Please upload evidence of your authority to act on behalf of the data subject

Max. file size: 50 MB.

3. Your Relationship with Dominion

Please tell us how you are connected with Dominion. Select all that apply.

Individual client

Settlor, beneficiary, protector or other party connected with a trust

Director, shareholder, beneficial owner or authorised person connected with a company or structure administered by Dominion

Investor or person connected with a fund or investment structure

Professional adviser or intermediary

Former client or former connected party

Prospective client

Other

How are you connected?

e.g. Name of relevant trust, company, fund, foundation, structure or client entity, if known, Dominion office or contact person, if known

4. What Personal Data Are You Requesting?

Please describe the personal data you would like to access. You may request all personal data that Dominion holds about you. However, if you are looking for specific information, giving us more detail will help us identify the relevant records more quickly.

Please select one option

I would like access to all personal data Dominion holds about me

I would like access to specific personal data, as described below

If your request relates to specific personal data, please describe what you are looking for

Helpful details may include: The relevant trust, company, fund, foundation or structure, The relevant Dominion office, Team or contact person, The type of information you are looking for, The approximate date range, The subject matter of correspondence or records, any specific documents, emails, files or transactions you are seeking.

5. Type of Information Requested

If helpful, please select the categories of information you are most interested in.

What other information are you interested in

6. Relevant Time Period

Start Date

End Date

Relevant Time Period Additional

I am not sure of the relevant dates

My request related to my full relationship with dominion

7. Additional Information to Help Us Locate Your Data

Please provide any other information that may help us identify the personal data you are requesting.

For example, you may wish to include file references, client entity names, previous email addresses, names of Dominion contacts, or details of relevant transactions or communications.

8. Proof of identity

To protect your personal data, we may need to verify your identity before disclosing information.

Please upload a copy of the following

Max. file size: 50 MB.

Passport, Driving licence, National identity card or another suitable identification document.

9. How Would You Like to Receive the Response?

Please select your preferred format.

Please note that Dominion may need to use a secure delivery method depending on the nature and sensitivity of the information.

What is your preferred method

10. Declaration

Please confirm the following:(Required)

Select exactly 4 choices.

I confirm that the information I have provided is accurate to the best of my knowledge.

I understand that Dominion may need to verify my identity before disclosing personal data.

If I am making this request on behalf of someone else, I confirm that I am authorised to do so and have provided evidence of that authority.

I understand that Dominion may contact me to clarify my request if reasonably required to identify the personal data requested.

11. Privacy Notice

Dominion will use the information provided in this form to assess, manage and respond to your Data Subject Access Request. This may include verifying your identity, confirming your authority to act on behalf of another person, locating relevant records, communicating with you about your request, and keeping records of how the request was handled. Dominion will process your personal data in accordance with applicable data protection law, including the Data Protection (Jersey) Law 2018. For more information about how Dominion uses personal data, please see our Privacy Notice. Privacy Notice

A form to request Dominion for access to personal data that we hold about you.