Request to delete personal information

For confidentiality reasons, you are entitled to request the deletion of certain personal information you provide.
This form refers to requests for the deletion of personal data collected by student CONCIERGE CLUB.

When you send your request, we try to maintain a balance between individuals’ privacy and the public rights to access that information. We can, for example, refuse the deletion of certain information, if it is related to financial scams, or criminal convictions.

Your information

* Required fields
Country of Residence *:

* Name (your name, even if you send an application on behalf of a third party that you are authorized to represent. If you represent a third party, you must be legally mandated to act on his/her behalf):


Name:

Adresse email de contact :

JI'm acting on behalf of: Myself, a client, a family member, a friend, other
Proof * (?):
Legal relationship with the applicant:
In order to avoid fraudulent requests for deletion based on impersonation, disloyal competition, or wrongly removing legal information, we will conduct an identity verification for the person who has created the application. We will only use your identification documents to verify the authenticity of the application.
The copy of this identification document will be deleted within a period of less than one month following the closing of the deletion request, unless otherwise provided by law.
Please identify the personal information you want to delete and their location:
Nature of Personal Data *:

Reason for deletion:

Declaration of authenticity:
I certify that the information contained in this application is accurate and that I am authorized to send this application. * I understand that student CONCIERGE CLUB will not be able to process my application if the form is not properly completed or if the Application is incomplete. *
Date *:

Signature (Full name)* :