Working draftPending AI Office template under Article 27(5)

Article 27 FRIA Template

Fundamental Rights Impact Assessment under Regulation (EU) 2024/1689, Article 27. Working template pending publication of the official AI Office questionnaire under Article 27(5). The six inputs below reproduce the wording of Article 27(1) verbatim. Free to use and adapt.

Section A — Organisation and system details

Organisation name
[entry]
Date of assessment
[entry]
AI system name and version
[entry]
Provider (if different from deployer)
[entry]
Member State(s) of deployment
[entry]
Annex III category
[entry]
Article 27 basis (public body / private entity providing public services / deployer of Annex III 5(b) or 5(c) system)
[entry]

Section B — The six Article 27(1) inputs

1

Description of deployer processes

A description of the deployer’s processes in which the high-risk AI system will be used in line with its intended purpose.

[free text]
2

Period and frequency of use

A description of the period of time within which, and the frequency with which, each high-risk AI system is intended to be used.

[free text]
3

Categories of affected persons and groups

The categories of natural persons and groups likely to be affected by its use in the specific context.

[free text]
4

Specific risks of harm

The specific risks of harm likely to have an impact on the categories of natural persons or groups.

[free text]
5

Human oversight measures

A description of the implementation of human oversight measures, according to the instructions for use.

[free text]
6

Risk materialisation response

The measures to be taken in the case of the materialisation of those risks, including the arrangements for internal governance and complaint mechanisms.

[free text]

Section C — Sign-off and filing status

Author
[entry]
Reviewer
[entry]
Sign-off date
[entry]
Article 27(2) notification to market surveillance authority (sent / pending / not applicable)
[entry]
Related GDPR Article 35 DPIA reference (per Article 27(3): the FRIA "shall complement" the DPIA where obligations overlap)
[entry]
Next review date
[entry]

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