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FORM OF APPLICATION FOR GRANTING ACCESS TO PUBLIC INFORMATION

FIRST AND LAST NAME / COMPANY / ENTITY: *

FULL ADDRESS: *

PURSUANT TO ARTICLE 2 SECTION 1 OF THE ACT OF 6TH SEPTEMBER 2001 ON ACCESS TO PUBLIC INFORMATION (THE JOURNAL OF LAWS NO.112 ITEM 1998 AS AMENDED) I SUBMIT A REQUEST FOR GRANTING ACCESS TO INFORMATION WITHIN THE FOLLOWING SCOPE:

APPENDIX:

MANNER AND FORM OF PROVIDING ACCESS TO INFORMATION: *

access to viewing information at PKP Polskie Linie Kolejowe S.A.
written form
computer files

To make it possible to process and execute this application I grant my consent for processing my personal data consisting in my first name, last name and address pursuant to the provisions of the Act of 29 August 1997 on Personal Data Protection (the Journal of Laws of 2002 No 101 item 926 as amended).
PKP Polskie Linie Kolejowe S.A. reserves itself the right to collect a charge for provided information pursuant to Article 15 of the Act on Access to Public Information.

Send information by mail to the address
(fill if the address is different than indicated in the data of the applicant)
Reception in person by the applicant on (dd-mm-yyyy)