FORMULAR ANKESE

Drejtuar
Komisionerit pr t Drejtn e Informimit dhe Mbrojtjen e t Dhnave Personale
N baz t Ligjit Nr. 119/2014 Pr t Drejtn e Informimit
Emri / Mbiemri :
Adresa:
Qyteti :
Telefon:
E-mail:
Autoriteti Publik :
Adresa:
Qyteti:
Identifikoni sakt Autoritetin Publik/Institucionin ndaj t cilit ankoheni.
Prshkruani do veprim t pretenduar si shkelje nga Autoriteti Publik dhe nse dispononi
dokumente bashklidhini ato.
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Prshkruani far krkoni nga Komisioneri pr t Drejtn e Informimit dhe Mbrojtjen e t
Dhnave Personale, n prputhje me nenin 24 t ligjit nr.119/2014.
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(Data)
(Firma)

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Ne nuk mund t pranojm ankesn nse nuk sht nnshkruar.

Informacioni n kt format dhe t dhnat e ID do t prpunohen n prputhje me ligjin pr

Mbrojtjen e t Dhnave Personale. Pr sqarime m t detajuara kontaktoni KDIMDP ose
koordinatorin e t drejts pr informim.

E rndsishme
Drgimi i ankess elektronikisht ose me post krkon bashklidhur nj kopje t karts s identitetit .