Request for personal information

For information on how the information you provide on this form will be processed, please view our privacy notice.

Request for personal information

Access to personal information - data held by Shropshire Council.

Please use this form to request personal information held by Shropshire Council.

To request such information we may ask you to provide proof of identity, such as a photocopy of your driving licence or passport.

Data protection statement
Shropshire Council will hold this information in accordance with current data protection legislation and will only use it for the processing of this request.

Your details

Applicants: Family name *

Applicants: First name *

Applicants: Middle name/initial

Applicants: Address line 1 *

Applicants: Address line 2

Applicants: Town *

Applicants: Postcode *

Applicants: Email *

Applicants: Telephone number *

Applicants: Alternative telephone number

Can you confirm if you have lived at any previous address? *

Yes
No

Previous address: Address Line 1 *

Previous address: Address line 2

Previous address: Town *

Previous address: Postcode *

Are you the applicant applying for information about yourself or an agent applying for information on behalf of someone else? *

Yourself
Someone else

Applicants: Date of birth *

Are you under 16 years of age? *

Yes
No

Application by a young person under 16 years of age

For applications made by anyone under the age of 16 years of age, a parent, guardian or Social Services care manager may be asked to certify that the Applicant fully understands the nature of this application

Parent/Guardian/Social Worker Details

Name *

Address line 1 *

Address line 2

Town *

Postcode *

Application by a third party or agent

There are a number of situations in which a third party may complete or contribute to the application.

Application by a third party or agent

Please provide details of the person on who’s behalf you are making this application for information.

Family name *

First name *

Middle name or initial

Address line 1 *

Address line 2

Town *

Postcode *

Date of birth *

What is your relationship to this person? *

Can you confirm if they have lived at any previous addressses? *

Yes
No

Previous Address: Address line 1 *

Previous address: Address line 2

Previous address: Town *

Previous address: Postcode *

I declare that I will not disclose any information that I am supplied with other than to the person on whose behalf I am acting

Access to a Child's information by parent or guardian

Childs: Family name *

Childs: First name *

Childs: Middle name/initial

Childs: Address line 1 *

Childs: Address line 2

Childs: Town *

Childs: Postcode *

Childs: Date of birth *

Childs: Previous address: Address line 1 *

Childs: Previous address: Address line 2

Childs: Previous address: Town *

Childs: Previous address: Postcode *

Relationship to child? *

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Request for personal information

Request for personal information

Your details

Application by a young person under 16 years of age

Parent/Guardian/Social Worker Details

Application by a third party or agent

Application by a third party or agent

Access to a Child's information by parent or guardian

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