Personal data disclosure request form - Afnic

Personal data disclosure request form
(AFNIC form)
To send back to:
AFNIC
Service Juridique
Immeuble International
78181 Saint Quentin en Yvelines
France
This form will allow you to ask AFNIC to remove the anonymity status of an individual holding a .fr domain name
registered with restricted publication.
AFNIC will study your request with regard to the information you are providing, as soon as possible and will disclose the
data in case of identical or similar to:
• Trademark already registered protected in France
• Already existing name or style of a company protected in France
• Already existing trade name or signboard registred in France
• Already existing title protected by French intellectual property rights (copyrights)
• Surname or pseudonym
AFNIC analysis will be essentially based on sign similarities.
In case of refusal, the other procedures intended by AFNIC’s naming Charter (obtaining a summary order injunction by a
judge or submit a case with the empowered Alternative Dispute Resolution Bodies) can be applied.
*Mandatory fields.
1. Information on the applicant
Name (Company) *
Name of the contact person *
Address *
(Street, City, Zip Code, Country)
E-mail address *
Phone number *
Fax number
www.afnic.fr

2. Information on the domain name
Domain name *
3. Reasons for the request
Please indicate in the box below the reasons for your request, with as much details as possible and enclose corresponding
certifications and/or any document justifying your intellectual property rights 1 .
AFNIC will answer your request on the basis of the documents that you will provide and will not carry on further
investigations:
1 Company identification certificate delivered by french chambers of commerce (K-bis), extract of INSEE data base
(French companies registry), association identification certificate, identity card etc.
4. Commitment of the applicant
The applicant undertakes to not use the data for other reasons that those mentioned in this form (and/or appendixes if
needed).
5. Date and signature
The collected information is processed by AFNIC (Registry for .fr and .re domain names), in charge of the handling in
order to remove the anonymity status in good conditions according to the article 23.2 of the .fr Naming Charter. The
recipient of the information is the Legal Department of AFNIC.
According to the French Data Protection Act (January 6, 1978, amended), you benefit from an opposition right for
legitimate reasons, and from access and rectification rights of your information. If you wish to obtain your collected
information, please make a request to AFNIC, Immeuble International, 78181 Saint Quentin en Yvelines, France.
www.afnic.fr
© AFNIC 2009 - Version March 2009.