Disclosing Personal Data (Police and other agencies)

Latest revision date: January 2023
Revision due date: January 2024



Who is this form for?


Organisations wishing to request disclosure of personal information held by Berneslai Homes must complete this request form. For the Police, the Authorising Officer must be ranked Police Inspector or higher and for other ‘relevant bodies’ a Senior Manager.
We are prepared to accept this completed and submitted E-form in replacement of a handwritten/wet signature. We may contact the authorising persons by phone or email to verify the request.
Please note: If the form has not been fully or properly completed and authorised you will be asked to re-submit your application. Note also that disclosure remains at the discretion of Berneslai Homes in the absence of a court order.


Protecting your personal data

By completing this form you acknowledge that we will follow our responsibilities under data protection legislation. We will store the information securely, share it with partners and other statutory agencies where we have the right under law to do this, use it only for the purpose it was provided and process it as set out in our privacy policy. For more information please see our privacy policy on our website www.berneslaihomes.co.uk
  • 1. Details of person making the request

  • First Name(s):

  • Last Name:

  • Job title:

  • Address:

  • Telephone:

  • Email:

  • 2. Person (s) you require information about (Data Subject)
  • Current details

  • First Name(s):

  • Last Name:

  • Current or last known address:

  • Other identifying information e.g. previous address, other names the data subject is known by, NI number

  • 3. Details of the information you require
  • Please be as specific as possible to help us identify the information you require from our many services e.g. housing repairs; customer services; housing management.

  • 4. Reason for request

  • 5. Reason why this disclosure is lawful
  • With reference to schedule 2 part 1 Para. 2/5 Data Protection Act 2018, and to articles 6(1) and 9(2) of the GDPR, state why this disclosure is lawful. If asking for information relating to criminal convictions and offences state your official authority and how you are authorised to process this information with regard to Article 10 GDPR or with reference to Schedule 1 DPA 2018.

  • 6. How would not providing the information requested prejudice the stated purpose?

  • 7. Information Provision

  • If we hold information how would you like the information to be provided?

  • 8. Declaration and Authorisation
  • The authorising officer must be of the rank of police inspector or higher, or for other ‘relevant bodies’ a senior officer/manger. In the case of an inspector not being available at your location, we will accept an email from an inspector (or higher ranking officer) attaching this paperwork and confirming their approval.

  • Declaration


    I certify that:
    • Information requested is compatible with the stated purpose (section 4) and will not be used in anyway incompatible with that purpose
    • I understand information given on this form is correct
    • I understand that if any information given on this form is incorrect, I may be committing an offence under Section 170 Data Protection Act 2018

  • Requestor:

  • Authorising Officer:

  • Authorising Officer First Name:

  • Authorising Officer Last Name:

  • Job Title

  • Contact Details