Authorisation Form for the Release of Personal or Sensitive Data

1. For Completion by Unit Requesting Data

i. Data User(This should be completed by the person requesting the data).

Name
E-mail
Job Title
Staff Number / Phone Number
Unit
Name of Head of Unit

ii. Intended Use of the Data

What data do your require?
In what format is this data wanted? (Please select one) / Labels / Data File
Please explain why the data is needed and what it will be used for:

iii. Security

If you are using this form for labels (as opposed to data for a label mail merge) go straight to section vii.

Data protection legislation states that all personal data should be surrounded by proper security. Please state where the personal data will be held.

1. / On any type of portable device or other locked away when not in use
2. / Password protected on your PC hard disk
3. / Password protected on a mainframe computer
4. / In a secure filing cabinet/cupboard
5. / Other, please specify
Item 5 specification:

iv. Destroying the Data

Please explain what will happen to the data when you have finished with its use:

v. Adding to the Data

Will you add to the data or modify it in any form? / Yes / No
If yes, please provide details (in some cases, a separate registration under data protection legislation will also be necessary):

vi. Disclosure of Data

Will you be disclosing this data to people outside of The Open University? / Yes / No
If yes, please provide details:

vii. Confidentiality Statement

I will be responsible for controlling access to the data. I agree to take personal responsibility for the data and will ensure the confidentiality and sensitivity of the data is not breached in any manner. I agree to abide by the rules of data protection legislation.

Name of Data User / Job Title / Date
Signature

I authorise the request of personal data.

Name of Head of Unit (or delegate) / Job Title / Date
Signature

This section should also be completed by any other person who will also have access to the data.

I agree to take personal responsibility for the data. I will ensure the confidentiality and sensitivity of the data is not breached in any manner. I agree to abide by the rules of data protection legislation.

Name of Nominee / Job Title / Date
Signature

Once this section is completed please send to Human Resources for authorisation.

2. For Completion by Human Resources

This form should be sent to Human Resources for authorisation.

I authorise the release of the personal data.

Human Resources Authorised Name / Job Title / Date
Signature

Management Information Report Request Form

1. For Completion by User Requesting Data

i. Data User(This should be completed by the person requesting the data). The following data fields are available in PIMS MI and will be supplied in Excel format. Please indicate below what data you wish to include within the requested report by ticking checkbox against the specific criteria.

General Option for Inclusion
Specify Report Date i.e. as at 01/01/2014
Include Staff on Unpaid Leave
Staff Details / Appointments / Appointments Details
Staff ID / Appointment No / Job Title
Title / Appointment Type / Hours per week
Initials / Appointment Start Date / Full-time/Part-time
Forenames / Appointment End Date / FTE
Surname / Termination Date / Weeks per year
Full Name / Termination Reason / Special Circumstances
OU Email / Resignation Reason / Job Share
OUCU / Appointment Role Code / Grade
Birth Date / Contract Type (Perm/FTC) / Salary Scale Point
Age / Probation End Date / Location Unit
Gender / Probation Ext. Date / Establishment Unit
Ethnic Origin / Probation Passed / PRO Category
SCE Start Date / Probation Period (months) / HERA Benchmark Code
STCE Start Date / Probation Review Date / HERA Benchmark Name
Disabled Indicator / Actual Salary / Home Address
Flexibly Retired / FTE Salary / Postcode
UK Country / Actual Staff Points / Country
UK Country 2 / FTE Staff Points
HESA Teach in Welsh
*Additional Requirements
Preferred Forename
Preferred Surname
Multiple Post Holder
If Multiple Post - other Job Title
If Multiple Post - other Role Code
If Multiple Post - other Establishment Unit
Other requirements (please specify):

*Please note that these additions will increase the time it will take to produce a report as this data will need to be derived for other system sources

Human Resources HRF020

May 2018

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