Request to Exercise Other Rights Related to Your Personal Data

You have several rights related to the storage and use of your Personal Data. The Right to Access Your Personal Data and the Right to Erase Your Personal Data are addressed in separate forms.

This form allows you to exercise these other rights:

Right to Change Your Personal Data

This is called the right to rectification. It gives you the right to ask us to correct, without undue delay, anything that you think is wrong with the Personal Data we have on file about you and complete any incomplete Personal Data.

Right to Ask Us to Limit How We Process Your Personal Data

This is called the right to restrict processing. It is the right to ask us to only use or store your Personal Data for certain purposes. You have this right in certain instances, such as where you believe the data is inaccurate or the processing activity is unlawful.

Right to Ask Us to Stop Using Your Personal Data

This is called the right to object. This is your right to tell us to stop using your Personal Data. You have this right where we rely on a legitimate interest of ours (or of a third party). You may also object at any time to the processing of your Personal Data for direct marketing purposes.

We will stop processing the relevant Personal Data unless: (i) we have compelling legitimate grounds for the processing that override your interests, rights, or freedoms; or (ii) we need to continue processing your Personal Data to establish, exercise, or defend a legal claim.

Right to Port or Move Your Personal Data

This is called the right to data portability. It is the right to ask for and receive a portable copy of your Personal Data that you have provided to us or that you have generated by using our Services or website, so that you can:

Move it;
Copy it;
Keep it for yourself; or
Transfer it to another organization.

We will provide your Personal Data in a structured, commonly used, and machine-readable format. When you request this information electronically, we will provide you a copy of it in electronic format.

Right Related to Automated Decision-Making

We sometimes use computers to study your Personal Data. We might use this Personal Data so we know how you use our services. For decisions that may seriously impact you, you have the right not to be subject to automatic decision-making, including profiling. But in those cases, we will always explain to you when we might do this, why it is happening, and the effect.

Right to Withdraw Your Consent

Where we rely on your consent as the legal basis for processing your Personal Data, you may withdraw your consent at any time. If you withdraw your consent, our use of your Personal Data before you withdraw is still lawful.

If you have given consent for your details to be provided to a third party and wish to withdraw this consent, please also contact the relevant third party in order to change your preferences.

Request to Erase Personal Data

SECTION 1: Details of Person Requesting Information

Your Full name(Required)

First Last

Your Address(Required)

Street Address City State / Province Zip / Postal Code

Your Email(Required)

Your Phone(Required)

SECTION 2: Are you the Data Subject?

Please tick the appropriate box and read the instructions which follow it.(Required)

YES, I am the data subject and HAVE accessed this form through a Wellbeing Workbench password protected account (in which case your login will be accepted as verification of your identity.) Please skip to SECTION 5.

YES, I am the data subject but have NOT accessed this form through the Wellbeing Workbench portal. In order for you to process my request, I will supply proof of my identity in SECTION 3, then skip to SECTION 5.

NO: I am acting on behalf of the data subject. I will supply proof of my identity in SECTION 3, proof of the data subject’s identity and written authority in SECTION 4, then continue to SECTION 5.

SECTION 3: Proof of Your Identity

If we are not satisfied you are who you claim to be, we reserve the right to refuse to grant your request.

Please supply us with a photocopy or scanned image (not originals) of your IDENTITY (passport, photo driver’s license, national identity card, birth certificate):(Required)

Max. file size: 100 MB.

Proof of your ADDRESS (utility bill, bank statement, credit card statement (no more than 3 months old)).:(Required)

Max. file size: 100 MB.

SECTION 4: Data Subject (Only) Details:

If we are not satisfied that the data subject is who you claim to be, we reserve the right to refuse to grant your request.

Data Subject's Full Name

First Last

Data Subject's Address(Required)

Street Address City State / Province Zip / Postal Code

Data Subject's Email

Data Subject's Phone

Proof of Data Subject's IDENTITY (passport, photo driver’s license, national identity card, birth certificate):(Required)

Max. file size: 100 MB.

Proof of Data Subject's ADDRESS (utility bill, bank statement, credit card statement (no more than 3 months old)).:(Required)

Max. file size: 100 MB.

Data Subject's Written Authority

Max. file size: 100 MB.

SECTION 5: Reason for erasure request

Given the sensitive nature of erasing personal data, GDPR Article 17(1) requires certain conditions to be met before a request may be considered. Please supply us with the reason you wish your data to be erased and please attach any justifying documents to this one.

Please tick the appropriate box:

You feel your personal data is no longer necessary for the purposes for which we originally collected it.

You no longer consent to our processing of your personal data.

You object to our processing of your personal data as is your right under Article 21 of the GDPR.

You feel your personal data has been unlawfully processed.

You feel we are subject to a legal obligation of the EU or Member State that requires the erasure of your personal data.

You are a child, you represent a child, or you were a child at the time of the data processing and you feel your personal data was used to offer you information society services.

SECTION 6: What information do you wish to erase?

Please describe the information you would like erased in as much detail as possible:(Required)

SECTION 7: Declaration

I confirm that I have read and understood the terms of this subject access form and certify that the information given in this application to It’s Elation, Inc. (Elation) is true. I understand that it is necessary for Elation to confirm my/the data subject’s identity and it may be necessary to obtain more detailed information in order to locate the correct personal data.(Required)

Signed Date

Please note that any attempt to mislead may result in prosecution. Documents which must accompany this application: · Evidence of your identity (See Section 3) · Evidence of the data subject’s identity, if different from above. (See Section 4) · Authorization from the data subject to act on their behalf (if applicable). · Justification for erasure of data (See Sections 5 & 6).

It's Elation Inc.

[email protected]

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