Application Form for Information Requests from Any Person

1. Name

2. Surname

3. Father's Name

4. NID Nr. i identifikimit personal

5. Gender MaleFemale

6. Date of Birth

7. Place of Birth

8. Nationality

9. Address

10. City

11. District

12. Postal Code

13. E-mail

14. Phone Number

15. Are you aware of the archival source of information: YesNo

a) Data on the applicant:

b) Research object:

c) Data that enables the localization of the requested information; When information on a specific individual is requested, the requester, in addition to the full generalities of the persons for whom information is requested, also presents other data that enables their localization, including but not limited to their addresses:

17. Argued interest of the applicant:

Photocopy of ID card/Passport

Proxy, when the application is submitted by an authorized representative.

I declare under my personal responsibility that the information and documentation received from the Authority will be used only for the requested purpose. I declare that I will not forward the information and documentation to other recipients. The applicant is responsible for the misuse of the documents/information, the damage caused and their use/publication in violation of the legislation in force.
I declare that I have been informed that pursuant to Law No. 45/2015, as amended, Article 20, point 4, when documents or duplicates, in addition to personal information on the applicant, also contain data on other affected persons or third parties, the examination of the original documents is guaranteed only when: a) this is approved by the other affected persons or third parties; or b) it is impossible to share the data on other affected persons or third parties; or c) it is possible only with unjustified efforts and there is no reason to presume that other affected persons or third parties have a legitimate interest in keeping this information confidential.
I declare that I have been informed that pursuant to Law No. 45/2015, as amended, Article 20, points 5, 6, the applicant is guaranteed the right to know and review even duplicates, in which personal information on other affected persons or third parties has been made illegible. The review is carried out at the offices of the Authority. Duplicates of documents are submitted to the applicant only after the personal data on other affected persons or third parties have been made illegible.

Nënshkrimi i kërkuesit

Deklaroj mora dijeni mbi rëndësinë e mbrojtjes së dhënave personale, dhe se për njohjen me dokumentet e identifikuara (nëse ka të tilla) firmosja e deklaratës së përgjegjësisë është e detyrueshme. Deklaroj se mora dijeni se mos nënshkrimi i deklaratës së përgjegjësisë, Autoritetit refuzon me vendim dhënien e aksesit mbi dokumentet/informacionet e identifikuara sipas kërkesës së paraqitur.

Nënshkrimi i Kërkuesit

Date of Signature

Privacy Policy I agree with the terms of use and privacy policy. Click here to read them.