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First Name

Last Name

Identification No. (ID) or Passport No.

Postal Address

Gender

Disability if any and Type (for statistical purpose only)

Telephone Number(s) where complainant can easily be reached

Email (if available)

Preferred mode of communication by the complainant

Physical address or location (for statistical purpose only

Detail of Respondent - Name and contact of respondent (individual or institution)

Date of occurrence of the alleged infringement

Name (s) of any person that can provide further information relevant to the complaint, if any

Nature of Complaint

Particulars of other persons impacted by the alleged infringement

Particulars of any person or institution that has previously made attempts to resolve the matter

Any actual or potential harm or any urgency to be taken note of

Avail any supporting documents to be used in an investigation process:

State in your own view what redress/relief you are anticipating

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Will you be affected by the Data Protection (Registration of Data Controllers and Data Processors)Regulations, 2021? Here is your chance to submit comments on the Regulatory Impact Statement available on https://t.co/JnhGl9AyfA.#DataProtectionKE #publicparticipation pic.twitter.com/ndYa0UdBmK
— OFFICE OF THE DATA PROTECTION COMMISSIONER (@ODPC_KE) May 20, 2021

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