Withdrawal of consent to the processing of personal data

Withdrawal of consent to the processing of personal data pursuant to § 14 of Act No. 18/2018 Coll.

I, (name, surname)

First

Last

Address

Address Line 1

City

State / Province / Region

Postal Code

I hereby revoke the consent of ENGIE Services a.s., with registered office at Jarošova 1, 831 03 Bratislava, ID No.: 35 966 289, registered in the Commercial Register kept by the District Court Bratislava I, Section : Sa, Insert No.: 3744/B, pursuant to Art. 6(1)(a) of the EU EPaR Regulation No. 2016/679 and pursuant to Act No. 18/2018 Coll. on the Protection of Personal Data and on Amendments and Additions to Certain Acts ( hereinafter referred to as " the Act ") with the processing of personal data and at the same time pursuant to Article 12 of Act No. 40/1964 Coll. of the Civil Code as amended

my Date Address

Place of signature