The Authorization To Disclose Information document is essential in Indonesian business and regulatory practices, particularly following the implementation of the Personal Data Protection Law (PDP Law) in 2022. This document is used when an individual or organization needs to formally authorize the sharing of specific information with designated recipients. It's commonly required in scenarios involving healthcare records, financial information, educational records, or other sensitive personal data. The document must comply with Indonesian data protection regulations, including proper consent mechanisms, specific purpose declarations, and data handling requirements. It serves as a legal safeguard for both the disclosing and receiving parties, ensuring transparent and authorized information sharing while maintaining data protection compliance.
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1. Authorizing Party Details: Full name, identification details (e.g., NIK/passport number), and contact information of the person giving authorization
2. Recipient Party Details: Full name and details of the organization/individual authorized to receive the information
3. Purpose of Disclosure: Clear statement of the specific purpose(s) for which the information is being disclosed
4. Information to be Disclosed: Detailed description of the specific information authorized for disclosure
5. Duration of Authorization: Specific period for which the authorization remains valid
6. Consent Declaration: Express statement of consent complying with Indonesian PDP Law requirements
7. Signature Block: Space for date, signature, and name of the authorizing party
1. Third Party Recipients: Section specifying any additional parties who may receive the information, used when information may be shared beyond the primary recipient
2. Revocation Rights: Details about the right to revoke authorization and the process for doing so, recommended for longer-term authorizations
3. Data Security Measures: Specific security measures required for handling the disclosed information, important for sensitive data
4. Electronic Consent: Additional provisions for electronic submission of authorization, required when using digital formats
5. Translation Declaration: Statement about the language versions if the document is bilingual, used when dealing with international parties
1. Detailed Information List: Comprehensive list of specific information/documents to be disclosed
2. Authorized Recipients List: Detailed list of all authorized recipients and their contact information when multiple recipients are involved
3. Security Protocol: Detailed security procedures and requirements for handling the disclosed information
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Banking & Finance
Insurance
Education
Legal Services
Human Resources
Government & Public Sector
Telecommunications
Real Estate
Professional Services
Relevant Teams
Legal
Compliance
Human Resources
Information Security
Risk Management
Operations
Administration
Medical Records
Data Protection
Corporate Governance
Relevant Roles
Data Protection Officer
Compliance Manager
Legal Counsel
Human Resources Director
Medical Records Administrator
Privacy Officer
Information Security Manager
Risk Management Officer
Corporate Secretary
Operations Manager
Administrative Officer
Records Manager
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