The Consent For Release of Information document is a crucial legal instrument used in Indonesia when personal data needs to be shared between organizations or individuals. This document becomes necessary whenever personal information needs to be disclosed to third parties, ensuring compliance with Law No. 27 of 2022 on Personal Data Protection (PDP Law) and related regulations. It is particularly important in scenarios involving sensitive personal data, cross-organizational information sharing, or when regulatory compliance requires documented consent. The document should be used when there is a legitimate need to share personal information, such as during medical treatment, financial applications, employment procedures, or educational purposes. It provides legal protection for both the data subject and the organizations handling the information by clearly documenting the scope, purpose, and limitations of the information release.
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1. Parties: Identification of the data subject (person giving consent) and the organization/entity requesting consent to release information
2. Background: Brief context explaining why the information release is needed and the relationship between the parties
3. Definitions: Clear definitions of key terms used in the document, particularly technical or legal terms
4. Information to be Released: Detailed specification of the exact information or categories of information to be released
5. Purpose of Release: Clear statement of how the released information will be used
6. Duration of Consent: Specification of how long the consent remains valid
7. Recipients of Information: Identification of who will receive the information and any third parties who may have access
8. Rights of the Data Subject: Statement of the data subject's rights under Indonesian law, including right to revoke consent
9. Data Protection Measures: Description of how the information will be protected during transfer and storage
10. Authorization Statement: Clear statement of consent and understanding, including confirmation that consent is given freely
11. Execution: Signature blocks and date of execution
1. Emergency Contacts: Used when the consent form relates to medical or emergency information, listing alternative contacts who may receive information
2. Special Categories of Data: Required when sensitive personal data (e.g., health, religious beliefs) is involved, providing additional protections and specific consent
3. International Transfer: Required when information may be transferred outside Indonesia, addressing cross-border data transfer requirements
4. Fees and Charges: Used when there are costs associated with the information release process
5. Language Declaration: Required when the consent form is bilingual or when the data subject's primary language is not Indonesian
1. Schedule A - Details of Information: Detailed listing of specific documents, records, or information to be released
2. Schedule B - Authorized Recipients: Complete list of authorized recipients and their contact details
3. Schedule C - Processing Activities: Detailed description of how the information will be processed, stored, and protected
4. Appendix 1 - Rights Summary: Summary of data subject rights under Indonesian law in simple language
5. Appendix 2 - Revocation Form: Template form for revoking consent if the data subject wishes to do so in the future
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Relevant Teams
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Data Protection
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Relevant Roles
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Information Security Officer
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Customer Service Manager
Administrative Officer
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Information Management Specialist
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