REQUEST FORM FOR DATA SUBJECTS UNDER THE LAW ON THE PROTECTION OF PERSONAL DATA NO. 6698
Please fill out the form below completely and accurately and send it to us so that your request to our company PRİMUM İLAÇ VE SAĞLIK HİZMETLERİ A.Ş. ("Company") can be fulfilled in accordance with the Law on the Protection of Personal Data ("LPPD").
We will respond to your request as soon as possible, depending on the nature of the request, and no later than thirty days. If the information and documents you provide to us are incomplete or incomprehensible, we will contact you to clarify your request.
Our Company reserves the right to request additional documents and information for identity and authorization verification in order to eliminate legal risks that may arise from unlawful and unfair data sharing and, in particular, to ensure the security of your personal data. Our Company does not accept responsibility for requests arising from incorrect or outdated information provided within the scope of the form or unauthorized applications. All responsibility arising from unlawful, misleading, or incorrect applications belongs to you. In accordance with the Communiqué on the Procedures and Principles of Application to the Data Controller, if our response to your application exceeds 10 pages, a transaction fee of 1 Turkish Lira will be applied for each page after the 10th page.
In this context, "written" applications to our Company can be submitted by printing out this form;
· In person,
· Via notary public,
· By sending it to our Company's e-mail address with documents proving the applicant's identity.
Information regarding how written applications will be delivered to us through specific written application channels is provided below.
Application Method
Address for Application
Information to be Stated in Application Submission
In-person application
(The applicant personally applies to our company headquarters with documents verifying their identity)
Maslak Mah. Taşyoncası Sok. Maslak 1453 Sitesi T4B Blok No:1U/232 Sarıyer/İstanbul-Türkiye
The envelope must state "Information Request under the Law on the Protection of Personal Data."
Notification via Notary Public
Maslak Mah. Taşyoncası Sok. Maslak 1453 Sitesi T4B Blok No:1U/232 Sarıyer/İstanbul-Türkiye
The notification envelope must state "Information Request under the Law on the Protection of Personal Data."
Application via e-mail
bildirim@primumpharma. The subject line of the e-mail must state "Information Request under the Law on the Protection of Personal Data."
1. Identity and Contact Information of the Personal Data Owner
Name-Surname:
T.C. Identity No:
Address:
Phone Number:
E-mail Address:
1. Your Relationship with Our Company
Your Relationship with Our Company:
1. Explanation of the Request
Please specify your request under the LPPD and the personal data subject to your request in detail.
1. Please select the method by which you would like to be informed of our response to your application:
· I want it to be sent to my address.
· I want it to be sent to my e-mail address. (If you choose the e-mail method, we will be able to respond to you faster.)
· I want to pick it up in person. (In case of delivery by proxy, a notarized power of attorney or authorization document is required.)
Applicant (personal data owner) *
Name Surname :
Date of Application :
Signature :
*If you are applying on behalf of someone else, please attach documents proving that you are authorized to apply (e.g., a document showing that you are the guardian/custodian of the personal data owner, a power of attorney). For these documents to be considered valid, they must be issued or approved by the competent authorities.