DATA SUBJECT ACCESS REQUEST FORM

You have the right to request access to or rectification of any personal information we may hold about you. You are a data subject when you provide us with personal information. If you wish to make such a request, please complete this form and return it to us by post or e-mail.

Did you know?

We collect information in order to properly identify you and process your request. This is a necessary information security measure to protect the communication and transfer of your personal information during the access request, rectification and complaint handling process. Unless we have your prior consent, we retain information only for the purposes necessary to process your request, and only for the time required to process your request. During this process, we may also share information with trusted partners, who are bound by security and confidentiality commitments. Would you like to deal with us directly, without using this form? You will find the contact details of our Privacy Officer below.

If sending by post, please use the following address :

Privacy Officer

Josiane Théorêt

Compagny name

Groupe Spinelli

Adress

200 Boul. Montreal-Toronto, Lachine, H8S 1B8

Country

Canada

If sending by e-mail, please use the following address: rprp@spinelli.com
Please write "Data subject access request" in the subject field of the e-mail.

1. Full name* :

2. Birth date* :

3. Current Adress* :

4. Contact details :

E-mail* :

Phone number* :

5. Details of information requested* :

6. To help us locate the information you need, please let us know what personal information you require in as much detail as possible (for example, copies of emails between [date] and [date]. If we do not receive sufficient information to locate the data you require, we may not be able to respond to your request.

7. Complaints handling

It is possible for you to inform us of a complaint concerning the processing of your personal information by our organization. Please identify the following information:

Description of the complaint (describe the events or circumstances, dates and periods involved, people involved) :

Description of the personal information that is the subject of the complaint :

Steps taken with us regarding the complaint :

The results sought by filing a complaint, for example :

Stop collecting unnecessary personal information.

Destroy your personal information.

Modify our practices according to the following criteria :

Other :

If applicable, attach any correspondence exchanged with us or relevant documentation concerning the complaint :

File number

If known, your file number :

8. Will the information be sent to the data subject or his/her representative ?
To the data subject
To the representative

If personal information is sent to the representative, sections 20 and 21 must be completed.

9. I confirm that I am the data subject and I agree to the following :

By checking the "I accept" box below, you agree that :

Documents are for personal and authorized use only.
You are under no obligation to provide documents electronically.
You can transfer any paper document to electronic form and destroy the original paper document, or change the format of any electronic document. The form in which a document is stored, as transfer, converted or migrated, is deemed to be an original for all purposes. Any such document remains fully enforceable in accordance with its terms.
In the event of any conflict between this consent and any provision of any other undertaking, the terms of this consent shall prevail.
You consent to receive, sign and retransmit documents electronically through the Metatracer and Upperity systems. Any documents you sign electronically through these systems are valid and enforceable as if they contained your handwritten signature.
I consent to your organization and Upperity processing my personal information for the purpose of verifying my identity and processing my request.
I agree and consent to your organization using the services of a third party in the process of verifying my identity. I understand and agree that a copy of my ID and proof of address documents (including government-issued ID) may be shared with a third party for the purpose of verifying my identity.
I understand that I may withdraw my consent at any time by sending an email communication to the Privacy Officer at the address identified above.

I agree*

If you are completing this form on paper, please complete the information below and sign the form by hand:

Name :

Date :

Signature :

If I do not use Upperity's electronic services, I enclose a certified copy by a lawyer, notary, notary public or commissioner of oaths of my identification and proof of address documents (including an identity document issued by the government of my country of citizenship) in accordance with the provisions of applicable privacy legislation.

10. (To be completed if the answer to question 8 is "To the representative")

The data subject (whose personal information is requested) must give written authorization for the information to be communicated to his/her authorized representative.

I hereby authorize (name of authorized representative) to request access to my personal information.

Signature of the data subject :

Name :

11. (To be completed by the representative of the data subject) I confirm that I am the authorized representative of the data subject.

Name of authorized representative and address where personal information should be sent :

Signature :

Name :

Date :

We will make every effort to process your data subject access request as quickly as possible within a maximum of 30 days from the date of receipt of your request. However, if you have any questions during the processing of your request, please do not hesitate to contact us at this e-mail address : rprp@spinelli.com