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DATA SUBJECT APPLICATION FORM
- GENERAL INFORMATION
Article 11 of the Law No. 6698 on the Protection of Personal Data grants personal data subjects, who are defined as data subjects in the Law No. 6698 on the Protection of Personal Data, the right to make requests regarding the processing of their personal data.
Pursuant to the first paragraph of Article 13 of the KVK Law; applications to be made to Kubba Sağlık Sanayi ve Ticaret A.Ş., the data controller, regarding these rights must be submitted in writing or by other methods determined by the Personal Data Protection Board.
- APPLICATION METHOD
Applications to be made to our Company shall be made by printing out this form;
- By personal application of the Applicant,
- It can be sent to us through a notary public or by signing with the secure electronic signature defined in the Electronic Signature Law No. 5070 by the Applicant and sending it to the registered e-mail address of Kubba Sağlık Sanayi ve Ticaret A.Ş.
Below, information on how to submit written applications is provided specific to the written application channels.
APPLICATION METHOD |
ADDRESS FOR APPLICATION |
APPLICATION SUBMISSION INFORMATION TO BE PROVIDED |
In Person Application | Kubba Health Industry and Trade Inc. | The envelope should be marked "Personal Data Protection Within the Scope of the Law Information Request" will be written. |
Application through Notary Public | Kubba Health Industry and Trade Inc. | The notification envelope should be marked "Personal Data Protection Within the Scope of the Law Information Request" will be written. |
Application via Registered Electronic Mail (KEP) Signed with "Secure Electronic Signature" |
| The subject line of the e-mail should read "Personal Data Protection Law Information Request" will be written. |
Pursuant to paragraph 2 of Article 13 of the KVK Law, your applications submitted to us will be responded within thirty days from the date of receipt of your request, depending on the nature of the request. Responses will be delivered to you in writing or electronically in accordance with the provision of Article 13 of the relevant KVK Law.
- APPLICATION FORM
Applicant Information
Name Surname |
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T.C. Identity Number |
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Nationality |
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Telephone Number |
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Address |
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Indicate your relationship with the company:
☐ Client
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☐ Business Partner
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☐ Visitor | ☐ Other |
☐ Former/Current Employee |
☐ Job Application / Resume Sharing |
Working Period: …………………………………………………. | History: ……………………………………………………………
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☐ I am a Third Party Company Employee | ☐ Other .................................................................... |
- RIGHTS OF THE APPLICANT
Pursuant to Article 11 of the Law, the rights that the applicant may request from our Company, which is the data controller, are as follows.
SUBJECT OF REQUEST | CHOICE |
I would like to learn whether my personal data is processed by your company (Art. 11/a of the LPPD) |
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If your company processes personal data about me, I request information about these data processing activities (Art. 11/b of KVKK) |
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I would like to learn the purpose of processing my personal data processed by your company and whether they are used in accordance with their purpose (Art. 11/c of KVKK) |
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If my personal data is transferred to third parties in Turkey or abroad, I would like to learn who or whom these third parties are (Art. 11/ç of the LPPD) |
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I believe that my personal data is incomplete or incorrectly processed and I want them to be corrected (Art. 11/d of the LPPD) |
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Although my personal data has been processed in accordance with the provisions of the law and other relevant laws, I think that the reasons requiring its processing have disappeared and within this framework, my personal data; 1) I request deletion. 2) I request anonymization (Art. 11/e of KVKK) |
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I want my personal data, which I believe to be incomplete and incorrectly processed, to be corrected by third parties to whom it has been transferred. Please write the personal data you want to be corrected in the blank space on the side, and send the documents showing the correct and complementary information as an attachment. (Art.11/f of KVKK) |
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I believe that my personal data processed by your company has been analyzed exclusively through automated systems and that as a result of this analysis, a result against me has emerged. I object to this result. (Art.11/g of KVKK) |
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I have suffered damage due to unlawful processing of personal data. I request compensation for this damage. Please write the matter subject to the violation of the law in the blank space on the side and send the supporting documents as an attachment. (KVKK art.11/ğ) |
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Please specify your request in detail within the scope of the KVK Law:
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Relevant information and documents should be attached to the application.
Please select the method by which you will be notified of our response to your application:
☐ I want it sent to my address.
☐ I want to receive it by hand.
In line with the requests I have stated above, I kindly request that my application to your Company be evaluated in accordance with Article 13 of the KVKK and that I be informed.
I hereby declare and undertake that the information and documents I have provided to you in this application are correct and up-to-date, that your Company may request additional information in order to finalize my application and that I have been informed that I may be required to pay the fee determined by the Personal Data Protection Board if it requires an additional cost.
Name and Surname of the Applicant :
Application Date :
Signature :