EU Personal Data Request Removal EU Privacy Removal Personal Information Removal Request Form Country of origin*AndorraAustriaBelgiumBulgariaCroatiaCyprusCzechiaDenmarkEstoniaFinlandFranceGermanyGibraltarGreeceGuernseyHungaryIcelandIrelandIsle of ManItalyJerseyLatviaLiechtensteinLithuaniaLuxembourgMaltaMonacoNetherlandsNorwayPolandPortugalRomaniaSan MarinoSlovakiaSloveniaSpainSwedenSwitzerlandUnited KingdomChoose your country/regionFull Legal Name* First Middle Last Your own name, even if you are making the request on behalf of someone else who you are authorised to represent. If you are representing someone else, you must have the legal authority to act on their behalf.Contact email address I am acting on behalf of....*MyselfA clientA family memberA friendIf you are submitting this request on behalf of someone else, please specify your relationship to that person (for example: "parent", "attorney"). We may ask for documentation confirming that you are authorised to represent this person.Your legal relationship to the person on whose behalf this request is made*Attach a legible copy of a document that verifies the identity of the person on whose behalf the request is made* Drop files here or Accepted file types: jpg, png, doc, pdf, xml. To prevent fraudulent removal requests from people impersonating others, trying to harm competitors, or improperly seeking to suppress legal information, we need to verify the identity of the person on whose behalf the request is made (the relevant individual). A passport or other government-issued ID is not required. You may obscure parts of the document (e.g. ID number) as long as the remaining information identifies the relevant individual. You may also obscure any photograph in the identification document, unless you are asking for removal of pages that include photographs of the relevant individual. Verplas Ltd will use this information solely to help us assess and document the authenticity of your request and will delete the copy within a month of closing your removal request except as otherwise required by law.Have you filed a previous request?*If you (or the relevant individual) have already asked us to remove URLs containing similar content, we can help you more quickly if you reply to the email we sent you (or the relevant individual) instead of sending a new notice. If you would rather send us a new notice, enter the 10-digit reference number from the previous request. As an example, the format will be similar to 1-1111-00000. You can find it in the subject line of the email we sent in response to the previous request.Personal information you want removed.*Please give examples of what personal information you want removed.Reason for removal*Please state how the personal information relates to the person on whose behalf this request is made and why you believe the personal information should be removed. For example: "You have a, b, c, personal data of mine on file. I would like it deleted because x, y,z."Sworn Statements* I consent to the processing of the personal information that I am submitting, as outlined below. Please read the following statements and check the boxes to confirm that you agree. Verplas Ltd will use the personal information that you supply on this form (including your email address and any ID information) and personal information you may submit in further correspondence for the purposes of processing your request and meeting our legal obligations. We may share details of your request with data protection authorities, but only when they require these details to investigate or review a decision that we have made. That will normally be because you have chosen to contact your national DPA about our decision. * I represent that the information in this request is accurate and that I am authorised to submit this request. * I understand that Verplas Ltd will not be able to process my request if the form is not properly filled out or if the request is incomplete. Signature*Signed on this date of (DD/MM/YYYY)Signature*Signature: e.g. Jo Ducting By typing your full name above, you are providing us with your digital signature, which is as legally binding as your physical signature. Please note that your signature must exactly match the first and last names that you entered at the top of this web form in order for your submission to be successful.