Download the personal data disclosure request form - Afnic

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Download the personal data disclosure request form - Afnic

To send back to :Personal data disclosure request form(AFNIC form)AFNICDirection Juridique et Politique de RegistreImmeuble International78181 Saint Quentin en YvelinesFranceThis form will allow you to ask AFNIC to remove the anonymity status of an individual holding of a domainname registered with restricted publication and for the extensions operated by AFNIC, such as : .fr , .pm , .re , .tf , .wf et .yt.AFNIC will study your request with regard to the information you are providing, as soon as possible and willdisclose the data in case of identical or similar to:• Trademark already registered protected in France,• Already existing name or style of company protected in France,• Already existing trade name or signboard protected in France,• Already existing title protected by Franch intellectual property rights (copyrights),• Surname or pseudonym.AFNIC analysis will be essentially based on sign similarities and not about websites contents.In case of refusal, the other procedures intended by AFNIC’s naming Charter (obtaining a summary orderinjunction by a judge or submit a case with the empowered Alternative Dispute Resolution Bodies) can beapplied..* Mandatory fields.1. Information on the applicantName (Company) *Name of the contact person *Adress *(Street, City, Zip Code, Country)E-mail adress *Phone number *Fax number *Disputed domain name *2. Reasons for the requestAssociation Française pour le Nommage Internet en Coopération | www.afnic.fr | contact@afnic.frTwitter : @AFNIC | Facebook : afnic.fr


Please indicate in the box below the reasons for your request, with as much details as possible and enclosecorresponding certifications and/or any document justifying your intellectual property rights (Companyidentification certificate delivered by French Chambers of Commerce (K-bis), extract of INSEE data base(French companies registry), association identification certificate etc.).AFNIC will answer your request on the basis of the documents that you will provide and will not carry onfurther investigations:3. Nature of information providedThe data that would be sent to you are « personal details » as defined by the French Data Protection Act, Lawn°78-17 of January 6, 1978.The information sent by AFNIC matches that entered by the registrar when the application to register thedomain name was submitted.*This information is sent to you on a strictly confidential basis.If AFNIC accepts your request, the personal details relating to the domain name holder concerned will be e-mailed to you. That e-mail itself is likewise protected by confidentiality of correspondence.4. Commitment of the applicantThe applicant undertakes to not use the data for other reasons that those mentioned in this form (and/orappendixes if needed).The applicant also undertakes to keep the personal details confidential and not to divulge them to any otherperson except on the instructions of a proper authority.The applicant also undertakes not to hold AFNIC liable for the personal details sent.5. Date and signatureAs required by the French Data Protection Act of January 6, 1978, as amended («the Act »), you are given notice that the information you send us is necessaryfor consideration of your request, and will be handled. Details marked * are compulsory: failure to provide them will prevent your request being considered. Theinformation collected from you will be handled by the person responsible (which is AFNIC – l’Association Française pour le Nommage Internet en Coopération)for the purpose of examining the Personal Data Disclosure Request sent to it under the Naming Policy for the extensions operated by AFNIC. The datarecipient is AFNIC’s Legal Department. You are entitled under the Act to object on legitimate grounds to the handling of your details, and/or to query andaccess details concerning you and to insist on their correction. To exercise any of these rights, please send your request in writing (enclosing proof of youridentity and signature) to AFNIC, Immeuble International, 78181 Saint Quentin en Yvelines, France.Association Française pour le Nommage Internet en Coopération | www.afnic.fr | contact@afnic.frTwitter : @AFNIC | Facebook : afnic.fr

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