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1. Employee Information: Section containing the employee's full identification details including name, employee ID, position, department, and contact information
2. Authorization Statement: Clear statement that the employee authorizes the release of specified information, including the purpose of the release
3. Information to be Released: Detailed specification of what types of information are authorized to be released (e.g., employment dates, position, salary, performance records)
4. Recipient Information: Details of the person(s) or organization(s) to whom the information will be released
5. Duration of Authorization: Specification of how long the authorization remains valid
6. Data Protection Notice: Statement about how the information will be protected and used, in compliance with Indonesian PDP Law
7. Revocation Rights: Information about the employee's right to revoke the authorization and the process for doing so
8. Signature Block: Space for employee signature, date, and witness signature if required
1. Third Party Disclosure Limitations: Additional restrictions on how the recipient may use or further disclose the information, used when sensitive information is being released
2. International Transfer Notice: Required when information may be transferred outside of Indonesia, including specific consent for international data transfer
3. Medical Information Release: Specific section for authorizing release of medical records or health information, used only when applicable
4. Electronic Consent Declaration: Required when the form will be executed electronically, including specific consent for electronic signature
5. Translation Declaration: Used when the form is provided in multiple languages, specifying which version prevails
1. Types of Information Checklist: Detailed checklist of specific information types that may be released, allowing employee to select which items they authorize
2. Privacy Policy Reference: Company's privacy policy regarding employee data handling and protection measures
3. Recipient Confidentiality Terms: Standard terms that recipients must comply with when handling the released information
Banking & Financial Services
Technology
Manufacturing
Healthcare
Education
Professional Services
Retail
Telecommunications
Construction
Government & Public Sector
Hospitality
Transportation & Logistics
Energy & Resources
Media & Entertainment
Human Resources
Legal
Compliance
Data Protection
Employee Relations
Personnel Administration
Information Security
Risk Management
Corporate Governance
Internal Audit
HR Manager
Data Protection Officer
Compliance Officer
Legal Counsel
HR Administrator
Personnel Manager
Privacy Officer
HR Director
Employment Relations Manager
Recruitment Manager
Benefits Administrator
HR Business Partner
Chief Human Resources Officer
Employee Relations Specialist
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骋别苍颈别鈥檚 Security Promise
Genie is the safest place to draft. Here鈥檚 how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; 骋别苍颈别鈥檚 AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it


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