Application Form for Information Requests from Any Person

Note: Please fill in the requested information below carefully and clearly. 

If you have any questions, please contact:
E-mail: info@autoritetidosjeve.gov.al

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SECTION A: INFORMATION ABOUT THE APPLICANT
SECTION B: LOCATION INFORMATION
16. Data that enables the localization of the requested information. To be determined:
SECTION C: SUBMITTED DOCUMENTATION
Documents
SECTION D: SIGNING THE DECLARATION OF LIABILITY

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.
I declare that I have been informed about the importance of personal data protection, and that for familiarization with the identified documents (if any) signing the declaration of responsibility is mandatory. I declare that I have been informed that failure to sign the declaration of responsibility will result in the Authority refusing by decision to grant access to the identified documents/information according to the submitted request.
The right to request information and make documents available under Law No. 45/2015 “On the Right to Information on Former State Security Documents of the People's Socialist Republic of Albania”, as amended, is exercised by individual applicants, by contacting the Authority for Information on Former State Security Documents through the postal service or at the Authority's information office.

    SECTION A: INFORMATION ABOUT THE APPLICANT

    1. Name
    2. Surname
    3. Father's Name
    4. NID Nr. i identifikimit personal
    5. Gender
    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

    SEKSIONI B: INFORMACION MBI KËRKUESINNëse Aplikanti dhe Kërkuesi janë i njëjti person, kalo në plotësimin e Seksionit C

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

    16. Data that enables the localization of the requested information. To be determined:

    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:

    SECTION C: SUBMITTED DOCUMENTATION

    Photocopy of ID card/Passport
    Proxy, when the application is submitted by an authorized representative.

    SECTION D: SIGNING THE DECLARATION OF LIABILITY

    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
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