Data Owner Application Form

TRUSELF HEALTH TOURISM AND CONSULTANCY SERVICES LIMITED COMPANY

DATA OWNER APPLICATION FORM

Application Method

You can submit your requests within the scope of your rights listed in Article 11 of the Personal Data Protection Law No. 6698 ("Law"), in accordance with Article 13 of the Law and Article 5 of the Communiqué on the Procedures and Principles of Application to the Data Controller, with this form and one of the methods explained below. You can send your application to Truself Health Tourism and Consultancy Services Limited Company (TRUSELF). We reserve the right to verify your identity before responding.

	APPLICATION METHOD	ADDRESS TO APPLY	INFORMATION TO BE SHOWN IN THE APPLICATION
. Application in Writing	Application in person with wet signature or via Notary Public	RASİMPAŞA MAH. MİSAK-I MİLLİ SK. TOPTAŞ İŞ HANI NO: 17 İÇ KAPI NO: 15 KADIKÖY/ İSTANBUL	“Information Request Within the Scope of the Personal Data Protection Law” will be written on the envelope/notification.
2. Via Registered Electronic Mail (KEP)	With registered e-mail (KEP) address	truselfsaglik@hs01.kep.tr	"Personal Data Protection Law Information Request" will be written in the subject line of the e-mail.
3. Application using the e-mail address in our system	By using your e-mail address registered in the TRUSELF system	PLEASE FILL IN	"Personal Data Protection Law Information Request" will be written in the subject line of the e-mail.
4. Application with an e-mail address not found in our system	By using your e-mail address that is not available in the TRUSELF system, including mobile signature/e-signature	PLEASE FILL IN	"Personal Data Protection Law Information Request" will be written in the subject line of the e-mail.

Your applications submitted to us will be responded to within thirty days from the date your request reaches us, depending on the nature of the request, in accordance with the 2nd paragraph of Article 13 of the Law. Our answers will be delivered to you in writing or electronically in accordance with the provision of Article 13 of the relevant Law.

Your Identity and Contact Information

Please fill in the fields below so that we can contact you and verify your identity.

Name surname
T.R. Identity Number / Passport Number or Identity Number for Citizens of Other Countries
Address of Residence Based on Notification
Mobıle Phone
Telephone Number
Faks Number
E-mail address

Please indicate your relationship with TRUSELF (such as customer, business partner, employee candidate, former employee, third-party company employee, shareholder).

☐ Customer

☐Visitor

☐Business partner

☐ Other:

Subject:

☐My Former Employee

Years I worked:

☐ Other:

☐ I Shared a Job Application / Resume

History :

☐ I am a Third Party Company Employee. Please specify the company and position information you work for:

Please specify your request within the scope of the Law in detail:
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 to be 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.)

This application form has been prepared to determine your relationship with TRUSELF and to fully determine your personal data processed by TRUSELF, if any, in order to respond to your application correctly and within the legal period. In order to eliminate legal risks that may arise from illegal and unfair data sharing and especially to ensure the security of your personal data, TRUSELF reserves the right to request additional documents and information (copy of identity card or driver's license, etc.) for identification and authorization determination. If the information regarding your requests submitted within the scope of the form is not accurate and up-to-date or an unauthorized application is made, TRUSELF does not accept liability for requests resulting from such incorrect information or unauthorized application.

NOTE: TRUSELF will finalize the requests made to it, free of charge, as soon as possible and within thirty days at the latest, depending on the nature of the request. If a cost arises due to fulfilling the requests, the fees in the tariff determined by the KVK Board may be requested.

Applicant (Personal Data Owner) Name and Surname:

Application date :

Signature :