Name of the Data Subject Surname of the Data Subject Name of the legal representative of the Data Subject (if applicable) Identity card of the Data Subject Identity document or equivalent document of the Legal Representative (if applicable) Address of the Data Subject or the Representative Email address, for the purpose of receiving notifications about this request: Telephone number of the Data Subject Telephone number of the Representative of the Data Subject (if applicable) State the right you wish to exercise Request for access to information.Request to update and rectify personal data.Request to erase information.Request to object to the processing of personal data.Request to suspend the processing of personal data.Personal data portability.Request to not be subject to a decision based solely or partly on automated processing. Description of the reason for the request Copy of the Identify Card of the Data Subject File format: pdf or .jpg / Maximum file size: 5MB Copy of the Identify Card of the Representative File format: pdf or .jpg / Maximum file size: 5MB Documents that support the request File format: pdf or .jpg / Maximum file size: 5MB I hereby authorize DIMUNE S.A. to respond to my request at the mailing address and/or email address recorded in this form.
