Data Subject Information Request and Application Form

As the data subject; The form below has been prepared in order to fulfil your requests to Dr.Barış Yiğit who is data controller.

IN ACCORDANCE WITH THE LAW ON PROTECTION OF PERSONAL DATA NUMBER 6698 (“KVKK”)

DATA SUBJECT INFORMATION REQUEST AND APPLICATION FORM

As the data subject; The form below has been prepared in order to fulfil your requests to Dr.Barış Yiğit who is data controller. You have to fill the form in this context and send it to us with the procedure presented below.

Application to be made; according to the nature of the request, it will be answered as soon as possible and within thirty (30) days at the latest. If the information in the request form that you have provided to us is incomplete, incorrect and/or incomprehensible, you will be contacted to clarify the application.

In order to eliminate the legal and actual risks arising from illegal and unfair data sharing and to ensure the security of personal data; additional documents and/or information may be requested from you for identification and authorization check.

We will not accept any responsibility for the requests arising from wrong information or the unauthorized application, in case of an unauthorized application or in case the information regarding your requests in the form is not correct and/or up-to-date. All responsibility arising from illegal or unlawful, misleading or inaccurate applications belongs to you. In addition, if an application is made with the personal data of another person without your authorization; we reserve the right to make legal, criminal and administrative applications regarding the issue.

If our response to the application you have made within the scope of the Communique on Application Procedures and Principles to Data Controllers exceeds 10 pages; a transaction fee of 1 Turkish Lira will be charged for each page after 10th one.

In this context, the applications to be made in “written” form by taking the print out of this form

• By personal application,

• Via notary public,

• By being signed by the applicant with the "secure electronic signature" defined in the Electronic Signature Law No. 5070 and sent to our registered e-mail address ………………..(kep address),

may be forwarded to us.

Application Method	Address to apply	Information to be Specified in the Application Submission
*in-person application* (Applicant comes to our center in person and applies with a document proving his identity)	Tuzla, Sadi Pekin Cd. No:4B/2, 48300 Fethiye/Muğla	“Information Request Under the Law on Protection of Personal Data” should be written on the envelope.
Notary public notice	Tuzla, Sadi Pekin Cd. No:4B/2, 48300 Fethiye/Muğla	“Information Request Under the Law on Protection of Personal Data” should be written in the notification envelope.
Application via registered electronic mail (KEP) by signing with a secure electronic signature	………………….. (kep adress)	"Personal Data Protection Law Information Request" should be written in the subject line of the e-mail.

1. Identity and Contact Information of Data Subject

Name- Surname:
ID No:
Address:
Telephone:
E-mail:

2. Your Relationship with Dr. Barış Yigit

Your relation:

Department you are in contact with:

3. Explanation About the Request

Please specify your request within the scope of KVKK and the personal data relating to your request in detail.

4. Additional Documents Related to the Subject

Please specify if there is any document you want to support your application and send the relevant documents with your application.

5. Please choose the method by which you will be notified of our response to your application:

 I want it sent to my address.

 I want it sent to my e-mail address. (We will be able to respond to you faster if you choose the e-mail method.)

 I want to receive it by hand. (In case of receipt by proxy, a notarized power of attorney or authorization document is required.)

Applicant (data subject) *

Name - Surname :

Application Date :

Signature :

* If you are applying on behalf of someone else, please send the documents showing that you are authorized to apply (such as a document showing that you are the parent/guardian of the data subject, power of attorney) in the annex of the application. In order for these documents to be considered valid, they must be issued or approved by the competent authorities.