Fill online: Employee data rights request: form, response letters and request log

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Your details

Name of the Company

Fills 7 places in the document.

E-mail address of the grievance officer

Fills 6 places in the document.

HR portal path or link for data rights requests

Name of the requester (1)

Current employee / Former employee / Candidate / Nominee of an employee / Other

Employee code or application reference of the requester

Registered e-mail address of the requester

Mobile number of the requester

Address of the requester for correspondence

Name of the employee for whom the nominee acts

Employee code of the employee for whom the nominee acts

Death of the employee / Incapacity of the employee

Death certificate / Medical certificate of incapacity / Other proof

Date of registration of the nomination

Yes / No (1)

Particular records or period, if any

Yes / No (2)

Data to be corrected, and the correct data

Yes / No (3)

Data to be completed or updated

Yes / No (4)

Data to be erased

Yes / No (5)

Consent to be withdrawn

Yes / No (6)

Name, relationship and contact of the nominee

Yes / No (7)

Describe the grievance

Documents enclosed in support, e.g. copy of the corrected certificate

Date of the request

Date of the acknowledgement

Reference number of the request

Name of the requester (2)

Date of receipt of the request

Types of request received

Date by which identification is to be sent

Date by which the reply is due

Name of the grievance officer

Designation of the grievance officer

Telephone number of the grievance officer

Date of the access reply

Identity and contact: Source

Identity and contact: Purposes

Identity and contact: Shared with

Identity and contact: Kept until

Government identifiers (PAN, UAN, ESIC: Source

Government identifiers (PAN, UAN, ESIC: Purposes

Government identifiers (PAN, UAN, ESIC: Shared with

Government identifiers (PAN, UAN, ESIC: Kept until

Employment and personnel file: Source

Employment and personnel file: Purposes

Employment and personnel file: Shared with

Employment and personnel file: Kept until

Pay, tax and benefits: Source

Pay, tax and benefits: Purposes

Pay, tax and benefits: Shared with

Pay, tax and benefits: Kept until

Attendance and leave: Source

Attendance and leave: Purposes

Attendance and leave: Shared with

Attendance and leave: Kept until

Performance and development: Source

Performance and development: Purposes

Performance and development: Shared with

Performance and development: Kept until

Data processed on your consent: Source

Data processed on your consent: Purposes

Date of the consent form

Data processed on your consent: Shared with

Data processed on your consent: Kept until

Other: Source

Other: Purposes

Other: Basis

Other: Shared with

Other: Kept until

Name of the payroll provider

Description of data shared with the payroll provider

Name of the group insurer

Description of data shared with the insurer

Other recipient

Data Fiduciary / Data Processor

Description of data shared with the other recipient

List of documents enclosed, or none

Information withheld, if any, with the reason, e.g. names of witnesses in an investigation

Date of the correction reply

Data, row 1

As it was, row 1

As it now is, row 1

Systems and records updated, row 1

Processors informed on, row 1

Data, row 2

As it was, row 2

As it now is, row 2

Systems and records updated, row 2

Processors informed on, row 2

Data, row 3

As it was, row 3

As it now is, row 3

Systems and records updated, row 3

Processors informed on, row 3

Data not changed, with the reasons, or none

Persons informed of the correction

Date of the erasure reply

Data erased, with the systems concerned

Backup cycle in days

Yes / No (8)

Date until which the wage registers are kept

Yes / No (9)

Yes / No (10)

Yes / No (11)

Yes / No (12)

Date until which the books are kept

Yes / No (13)

Date until which the tax records are kept

Yes / No (14)

Date until which the social security records are kept

Yes / No (15)

Matter concerned

Yes / No (16)

Date of the reply declining the request

Part of the request declined

Date of the letter seeking identification

Yes / No (17)

We have not been able to identify you: Explanation

Steps taken as a matter of policy

Yes / No (18)

The data is processed for the purposes of: Explanation

Yes / No (19)

Law and period concerned

Yes / No (20)

The data is needed for the specified purpose: Explanation

Yes / No (21)

The data is needed to establish, exercise or: Explanation

Yes / No (22)

The data is processed in the investigation: Explanation

Yes / No (23)

Disclosure would reveal the personal data of: Explanation

Yes / No (24)

The material is legal advice that is: Explanation

Date of the earlier reply

Yes / No (25)

The request repeats a request answered on: Explanation

The rest of your request is answered separately / No part of your request could be met

Designation of the reviewer of declined requests

Ref., row 1

Received on, row 1

Requester and code, row 1

Type (A to G), row 1

Identity verified on, row 1

Reply due (30 days from receipt), row 1

Replied on, row 1

Met / Partly met / Declined (1)

None / Grievance / Board (1)

Handled by, row 1

Ref., row 2

Received on, row 2

Requester and code, row 2

Type (A to G), row 2

Identity verified on, row 2

Reply due (30 days from receipt), row 2

Replied on, row 2

Met / Partly met / Declined (2)

None / Grievance / Board (2)

Handled by, row 2

Ref., row 3

Received on, row 3

Requester and code, row 3

Type (A to G), row 3

Identity verified on, row 3

Reply due (30 days from receipt), row 3

Replied on, row 3

Met / Partly met / Declined (3)

None / Grievance / Board (3)

Handled by, row 3

Ref., row 4

Received on, row 4

Requester and code, row 4

Type (A to G), row 4

Identity verified on, row 4

Reply due (30 days from receipt), row 4

Replied on, row 4

Met / Partly met / Declined (4)

None / Grievance / Board (4)

Handled by, row 4

Ref., row 5

Received on, row 5

Requester and code, row 5

Type (A to G), row 5

Identity verified on, row 5

Reply due (30 days from receipt), row 5

Replied on, row 5

Met / Partly met / Declined (5)

None / Grievance / Board (5)

Handled by, row 5

Ref., row 6

Received on, row 6

Requester and code, row 6

Type (A to G), row 6

Identity verified on, row 6

Reply due (30 days from receipt), row 6

Replied on, row 6

Met / Partly met / Declined (6)

None / Grievance / Board (6)

Handled by, row 6

Three (1)

Seven

Designation to whom overdue requests are escalated

Three (2)

Scope. The right of access (s.11) and the right to correction and erasure (s.12) apply under the Act to personal data processed on consent, including data given voluntarily under s.7(a). Most employment data is processed under the legitimate use in s.7(i) and falls outside those two rights, but the right of grievance redressal (s.13) is not so limited, and the Company's privacy notice extends this procedure to all the personal data it holds as a matter of policy. Answer every request through this format; where you rely on the statutory limit, say so in Part 6 rather than ignoring the request. Commencement. The rights in ss.11 to 14 and Rule 14 apply from 13.05.2027. Until then, rule 5(6) of the SPDI Rules 2011 lets a person review and correct the information given, and rule 5(9) requires grievances to be redressed within one month. Timelines. Rule 14(3) requires the Company to publish a period, not exceeding ninety days, for responding to grievances. This format works to thirty days for every request and grievance, which meets both regimes. Every reply carries the contact details of the person who answers questions on the Company's behalf (Rule 9).

Part 1 · Data rights request form

[Name of the Company] · To be submitted to the grievance officer at [E-mail address of the grievance officer] or through [HR portal path or link for data rights requests]

1. About you

Particulars	Entry
Name	[Name of the requester]
You are	[Current employee / Former employee / Candidate / Nominee of an employee / Other]
Employee code, or application reference for a candidate	[Employee code or application reference of the requester]
E-mail address registered with the Company	[Registered e-mail address of the requester]
Mobile number	[Mobile number of the requester]
Address for correspondence	[Address of the requester for correspondence]

2. If you are a nominee. Name of the employee: [Name of the employee for whom the nominee acts] · Employee code: [Employee code of the employee for whom the nominee acts] · Ground: [Death of the employee / Incapacity of the employee] · Proof enclosed: [Death certificate / Medical certificate of incapacity / Other proof] · Nomination registered with the Company on: [Date of registration of the nomination]

3. What you are asking for

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