Complaint Form for Personal Data Protection Concerns

(500 characters remaining,if insufficient please attach documents)


(2000 characters remaining,if insufficient please attach documents)

We note that you are submitting a complaint on an organisation's refusal or failure to provide access/correct your personal data, or the fee required in relation to your request to access your personal data.

Under section 28 of the Personal Data Protection Act, the Commission may, upon application of a complainant, review a refusal or failure to provide access/to correct personal data requested. Upon completion of the review, the Commission may:

  • direct the organisation to provide access to the personal data, or confirm the refusal to provide access to the personal data, within such time as the Commission may specify;
  • direct the organisation to correct the personal data, or confirm the refusal to correct the personal data, in such manner and within such time as the Commission may specify; or
  • confirm, reduce or disallow a fee, or direct the organisation to make a refund to the complainant.

If you wish to apply to the Commission to review the matter, please complete the following section.

Part 1 - Matter the Applicant is requesting the Commission to review under section 28(1) of the PDPA [please check the relevant box(es)]




Part 2 - Facts and circumstances, and reasons for Review Application

(2000 characters remaining, if insufficient please attach documents)


Part 3 - Decisions or directions sought by the Applicant [please check the relevant box(es)]

You may list the specific personal data / information or refer to an attached document that lists the requested personal data / information
(2000 characters remaining, if insufficient please attach documents. )

You may list the specific corrections or refer to an attached document that lists the corrections
(2000 characters remaining, if insufficient please attach documents. )


Part 4 - Additional Documents to be Submitted
Additional Documents to be Submitted
  1. A copy of your NRIC or FIN (both sides) or the relevant page of your passport that states your name and other identification details
  2. A copy of your Access Request or Correction Request to the Organisation in respect of which you are making this Review Application
  3. A copy of every written reply from the Organisation to you in relation to your Access Request or Correction Request referred to in paragraph (b)
  4. A supporting statement and/or a copy of any other document that you may wish to rely on

If items (b) or (c) are not available, please explain below why those documents are not available. If item (b) is not available, please also summarise what was requested in your Access Request or Correction Request to the Organisation

(2000 characters remaining, if insufficient please attach documents)


(Attachment must be in .JPG, .JPEG, .PDF, .DOC, .DOCX, .XLS, .XLSX, .PNG or .MSG format. Max size per file is 2MB)

By submitting this complaint, I confirm that the account as stated above is true and correct. I understand that any false or misleading information provided by me may constitute an offence under Section 51(3)(c) of the Personal Data Protection Act and/or section 182 of the Penal Code.

I understand that the information provided by me in this complaint may be used and disclosed by the PDPC in accordance with the Act and regulations thereunder, including (but not limited to) for the purposes of investigations, proceedings and other actions by the PDPC under the Act. Without limiting the foregoing, I understand that some or all of the information provided by me in this complaint may be disclosed in accordance with the Act to other parties including (amongst others) the organisation that is the subject of this complaint and/or other government agencies.

I further understand that I may be required to give a formal statement and appear before PDPC in relation to the statement or other matters within my knowledge.

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Last updated on 12 May 2016