Application for the use of confidential data for scientific purposes

Name of legal person or organisation

Registry code

Title of research

Research objective

Link to research in research portal (URL)

Ethics committee and/or the Data Protection Inspectorate permission

Yes

Requested data (statistical activity / survey / list of data)

Data from other sources

Indicate other datasets that you intend to use during the analysis.

Research publication method

List of persons wishing to use the data for research:
Name Personal ID code E-mail

Signed by:

Name

Job title

Start date of data use

End date of data use

Additional information

CAPTCHA

* The data are provided in csv format.

* If it is necessary to use a prepared software source code (e.g. R code), please specify the date of its submission under “Additional information”.