PENTLAND HOUSING ASSOCIATION LIMITED

INFORMATION REQUEST FORM

Please complete this form to make a request for information to the Association.  Please use the “Additional Information” section at the end of the form if you need more space.	
Your details	
Forename
		
Surname		
Post or e-mail address
(required to allow the Association to contact you about or respond to your request)		
Telephone number
(required in case the Association needs to contact you about your request)		
Please describe the information that you would like to have access to, including any specific dates (if appropriate).  The Association may contact you to clarify your request.	

	
Please specify how you would like to receive the information.	
  Electronic format 
  e-mail 
  memory stick
  Print-outs (by post)
  Inspection at the Association’s office	
Please specify if you would like the information to be provided to you in a particular format e.g. large print, Braille, audio tape.  We will try to accommodate your preferred format, although we may not always be able to do so.	

	
Please include any other information which may help the Association to process and respond to your request.	

	
Signature		Date		
Please complete this form and return it to:	
By post:
The Data Protection Officer
Pentland Housing Association Limited
37-39 Traill Street
Thurso
KW14 8EG

	By e-mail:
The Data Protection Officer
pentland-dpo@infolawsolutions.co.uk
	
Fees
The Association may charge you a fee for providing the information that you have requested in accordance with the Association’s Access to Information Charging Statement available on the Association’s website at: https://www.pentlandhousing.co.uk/pentland-useful-documents or from the Association’s office.  
Fees must be paid in advance of the information being provided to you.	
How the Association will use your personal information
The Association will use the personal information that you provide on this form to comply with its legal obligation to process your request for information in accordance with the Freedom of Information (Scotland) Act 2002 (FOISA) and / or the Environmental Information (Scotland) Regulations 2004 (EISRs).  It will also be used to monitor the Association’s compliance with FOISA and the EISRs.  The Association may use your contact details to contact you to clarify your request and / or to provide you with advice and assistance.
Further information on how the Association uses your personal information, including your rights, is contained within the Association’s “Transparency Statement (Access to Information Requests)”.  This will be provided to you as part of the acknowledgement of your request. 	

	

	

	

	

	

	

	

	

Additional information