Consent For Access To Information Form

Consent For Access To Information Form Template for Indonesia

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Key Requirements PROMPT example:

"I need a Consent For Access To Information Form for our Jakarta-based medical research facility to collect and process patient health data, including permission to share anonymized data with international research partners, effective from March 2025."

Document background

The Consent For Access To Information Form is a crucial document required under Indonesian data protection law, particularly following the implementation of Law No. 27 of 2022 (PDP Law). This document is essential when organizations need to collect, process, or share personal information about individuals. It serves as a legal safeguard ensuring that data subjects are properly informed and have explicitly authorized access to their information. The form should be used whenever an organization requires access to personal data beyond basic contact information, especially for sensitive data categories or when information sharing with third parties is involved. It includes specific provisions required by Indonesian law regarding data protection measures, duration of consent, and the rights of data subjects. The document is particularly important given Indonesia's strengthened data protection framework and increased scrutiny of data processing activities.

Suggested Sections

1. Data Subject Information: Personal details of the individual granting consent (name, ID number, contact information)

2. Data Controller Information: Details of the organization/entity requesting access to information

3. Purpose of Information Access: Clear statement of why the information is being requested and how it will be used

4. Scope of Information: Specific details of what information is being authorized for access

5. Duration of Consent: Time period for which the consent remains valid

6. Rights of the Data Subject: Statement of rights under Indonesian law including right to withdraw consent

7. Data Protection Measures: Summary of how the information will be protected and secured

8. Declaration and Signature: Formal acknowledgment and signature section for all parties

Optional Sections

1. Third Party Disclosure: Include when information may be shared with third parties, listing specific parties or categories

2. International Data Transfer: Required when information may be transferred outside Indonesia

3. Special Categories of Data: Include when collecting sensitive personal data such as health information, religious beliefs, or biometric data

4. Emergency Contact Authorization: Include when access to emergency contact information is part of the scope

5. Witness Section: Include when additional verification of consent is required or when dealing with sensitive information

Suggested Schedules

1. Schedule A - Detailed Information List: Comprehensive list of specific information items being authorized for access

2. Schedule B - Authorized Recipients: List of specific individuals or roles authorized to access the information

3. Schedule C - Security Protocols: Detailed description of security measures and data protection protocols

4. Appendix 1 - Data Subject Rights Guide: Detailed explanation of data subject rights under Indonesian law

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok��˰� | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

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