Data Protection

Subject Access Request Form

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Subject Access Request (External) Form: v1 1 Please complete the subject access request form below and email to along with a copy of proof of ID. Proof of ID can include passport, driving license, birth certificate or national ID card. The organization will respond within one calendar month starting from the day after receipt of this request. If the request is complex, we may take up to three calendar months to respond, however if this is the case Liminal BioSciences Inc. will inform you of the extension within the initial one-month period. If Liminal BioSciences Inc. finds the request to be manifestly unfounded or excessive, we may charge an administration fee. Section 1: Applicant Information Title: Forename: Middle Name: Surname: Address: Post Code: Company Name (if applicable): Contact Telephone Number: Email Address: Section 2: Request Information What information/change to details are you requesting? Please use this space to give us any details about the information you are requesting, for example by stating specific documents you require (use extra sheets if necessary): Example: My account history from 2014 to 2017 held by the sales and marketing team at Liminal BioSciences Inc. Please explain the information/change to details? Subject Access Request (External) Form

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