POPIA / PAIA electronic form

Objection To The Processing Of Personal Information

Use this form to object to the processing of your personal information by FaceCamAlert or a responsible party using FaceCamAlert.

Annexure B · Form 1

Objection to the processing of personal information in terms of section 11(3) of the Protection of Personal Information Act, 2013 (Act No. 4 of 2013)

Regulations Relating to the Protection of Personal Information, 2017 [Regulation 2(1)]

Note:

Affidavits or other documentary evidence in support of the objection must be attached.
If the space provided for in this Form is inadequate, submit information as an Annexure to this Form and sign each page.

Reference number: FCA-OBJ-20261110-U8KH9

Name and surname of data subject *

Residential, postal or business address *

Contact number(s) *

FAX number

E-mail address *

The responsible party is *

A natural personA public or private body

Name of public or private body (if the responsible party is not a natural person) *

Business address

Contact number(s)

FAX number

E-mail address

Subject

Reasons for objection *

Affidavits or other documentary evidence in support of the objection *

PDF or images, up to 8 files of 10 MB each. Files are stored privately and are only visible to FaceCamAlert's authorised staff.

Date

10 November 2026

Signature of data subject (applicant): type your full name *

I confirm that the information in this form is true and correct, and that typing my name above serves as my signature on this form.

Annexure C

1	Standard fee for any request to be processed regardless of success of request.	R200
2	If successful the following amount is payable for the provision of feedback, footage and documentation where applicable.	R400