Application Form Regarding the Processing of Personal Data

PROF. SELCUK INANLI

Application Form Regarding the Processing of Personal Data

 

 

Preliminary Remarks

 

The Law on the Protection of Personal Data No. 6698 (hereinafter referred as “PPD”), personal data owners (hereinafter referred as “Applicant”), has been defined as the data subject in Article 11 of the PPD.

 “Learning whether their personal data is processed, requesting information if their personal data has been processed, learning the purpose of processing their personal data and whether they are used in accordance with their purpose, knowing the third parties to whom their personal data is transferred, in the country or abroad, and correcting them if their personal data is incomplete or incorrectly processed. requesting the deletion or destruction of personal data in the event that the reasons requiring processing are eliminated, although it has been processed in accordance with the provisions of the Law and other relevant laws, and requesting the deletion or destruction of personal data within this scope, to request the notification of the persons, to object to the emergence of a result against him by analyzing the processed data exclusively through automated systems, to incur losses due to the unlawful processing of personal data. demanding the compensation of the damage in” right has been granted.

 

Pursuant to the first paragraph of Article 13 of the PPD; Applications to be made regarding these rights must be submitted Prof. Selcuk Inanlı in writing or by other methods determined by the Personal Data Protection Board (hereinafter referred as “Board”).

 

With this regard, applications to be made to PROF. SELCUK INANLI in written, by printing out this agreement;

 

  • With the personal application of the Applicant,
  • Via co-operation with public notary,
  • By means of an e-mail to [email protected] by the Applicant,
  • The "secured electronic signature" as defined in the Electronic Signature Law No. 5070 by the Applicant can be sent to Prof. Selcuk Inanlı being signed with a "mobile signature" and sent to the Registered Electronic Mail (hereinafter referred as “REM”) address.

 

Hereupon, information regarding how written applications will be delivered to to Prof. Selcuk Inanlı specific to the written application channels, is given.

 

Application Method

 

Address to apply

 

Information to be specified in the application submission

 

Personal Application

(The applicant himself will

come and prove his/her identity

with a valid document)

 

Hakkı Yeten Cd. No: 13/22 Terrace Residence Fulya, Şişli / Istanbul

"Information request pursuant to the PPD" will be written on the envelope.

 

Through a public notary

notification

 

Hakkı Yeten Cd. No: 13/22 Terrace Residence Fulya, Şişli / Istanbul

"Information request pursuant to the PPD" will be written on the envelope.

 

Via e-mail

 

[email protected]

 

 

 

"Information request pursuant to the PPD" will be written on the subject of the e-mail.

 

 

Applications that have been submitted to Prof. Selcuk Inanlı pursuant to paragraph 2 of article 13 of the PPD; In written applications, the date of notification of the document Prof. Selcuk Inanlı in applications made by other methods, the date of receipt of the application to our company is the application date. Depending on the nature of the request, it will be answered free of charge within 30 (thirty) days from the date of receipt of your request. However, in case of a written response, no fee is charged for up to ten pages, and a processing fee of 10 Turkish Liras may be charged for each page over ten pages. If the response to the application is given in a recording medium such as CD or flash memory, the fee that may be requested by our company cannot exceed the cost of the recording medium. Our answers are delivered to you in writing or electronically in accordance with the provisions of Article 13 of the relevant PPD.

 

A. Contact informations of the Applicant:

 

Name:

 

 

Surname:

 

 

T.R. Identification number:

(Passport number for foreigners or identification number, if any)

 

 

Phone number:

 

 

Email:

(For rapid responses please indicate)

 

 

 

Address:

 

 

 

 

 

 

B.
Please indicate your relationship with Prof. Selcuk Inanlı (Employee, prospective employee, former employee, members, visitors, patients receiving services, 3rd party company employees, etc.)

 

 

☐ Employee

☐ Visitor


Customer/Potential customer/member

 

☐ Prospective Employee

☐ Other:

……………………………………………………………..

 

 

Request No.

 

Demand

 

Your choice

 

  1.  

I want to know whether my personal data is processed by your company. [PPD Art. 11/1 (a)]

 

  1.  

If my personal data has been processed by your company, I request information about it. [PPD Art. 11/1 (b)]

 

  1.  

I would like to learn the purpose of processing my personal data and whether it is used in accordance with the purpose of processing. [PPD Art. 11/1 (c)]

 

  1.  

If my personal data is transferred to third parties domestically or overseas, I would like to learn about these third parties. [PPD Art. 11 /1 (d) ]

 

  1.  

I believe that my personal data is incomplete or incorrectly processed and I request their correction. Please send your petition indicating that which of the personal data you want to be corrected, in accordance with the documents showing the correct and complementary information as an attachment. (Copy of identity card, residence, etc.) [PPD Art. 11 /1 (d)]

 

  1.  

I believe that the reasons requiring the processing of my personal data have disappeared, and with this reagard, my personal data;

a) I request it to be deleted.

b) Anonymization

I demand. [PPD Art. 11 /1(e)]

 

  1.  


I would like to inform the third parties to whom my personal data has been transferred, of the actions taken pursuant to my rectification request (Request No 5). [PPD Art. 11/1 (f)]

  8.

I would like to inform the third parties to whom my personal data has been transferred, of the actions taken pursuant to my request for deletion or destruction (Request No. 6). [PPD Art. 11/1 (f)]

 

  9.

I believe that there is an occurrence against me by analyzing my personal data processed by your company exclusively through automated systems. I would like oppose to this conclusion.

 

Please send your petition regarding the analysis result that you think is against you and the documents supporting your objection as an attachment. [PPD Art. 11 /1 (g) ]

 

  10.

I suffered damage due to the illegal processing of my personal data. I demand that this damage be compensated.

Please send the documents related to the subject of the violation of the law as an attachment. (Court decision, Board decision, documents showing the amount of material damage, etc.) [PPD Art. 11/1 (ğ)]

 

 

 

 

C. Please choose the method of notification to your application:

☐ I want it sent to my address.

☐ I want to receive it by hand. (In case of receipt by power of attorney, notarized power of attorney or certificate of authorization must be submitted.)

☐ I want a reply to my e-mail address that I sent the form to and registered in your system.

 

This application form has been furnished in order to determine your relationship with Prof. Selcuk Inanlı and to fully determine your personal data, if any, and to respond to your relevant application in a correct and legal time. Prof. Selcuk Inanlı reserves the right to request additional documents and information (copy of identity card or driver's license, etc.) for identification and authorization in order to eliminate legal risks that may arise from illegal and unfair data sharing and especially to ensure the security of your personal data. In the event of that the information regarding your requests you submit within the scope of the form is not correct and up-to-date or an unauthorized application is made, Prof. Selcuk Inanlı does not accept any responsibility for such false information or requests arising from unauthorized applications.

 

APPLICANT STATEMENT

I hereby demand that the application I have made pursuant to the Law on the Protection of Personal Data No. 6698 be evaluated and concluded within the framework of the above-mentioned request/requests, I accept, declare and undertake that the information and documents I have provided to you in this "Application to Data Controller" are correct, up-to-date and belong to myself.

 

Applicant’s:

Name and surname:

Application date:

Signature: