The Privacy Act Release Form is a critical document used in Indonesia when organizations need explicit consent to collect, process, or share personal data in compliance with Law No. 27 of 2022 on Personal Data Protection (PDP Law) and related regulations. This document becomes necessary whenever an organization needs to handle personal data beyond basic processing, particularly in situations involving sensitive data, third-party sharing, or cross-border transfers. The form should be used to document informed consent, outline specific data processing activities, and clarify the rights and obligations of all parties involved. It's particularly important in contexts where clear documentation of privacy-related authorizations is required, such as healthcare settings, financial services, or when handling sensitive personal information.
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1. Parties: Identification of the data subject (individual giving consent) and the organization/entity receiving the authorization
2. Background: Context explaining the purpose and necessity of the privacy release
3. Definitions: Clear definitions of key terms used in the form, including 'personal data', 'processing', 'consent', and other relevant terms as defined in the PDP Law
4. Scope of Personal Data: Detailed specification of what personal data is covered by the release
5. Purpose of Data Processing: Clear statement of how the personal data will be used and processed
6. Consent Declaration: Express declaration of consent for the collection, processing, and sharing of personal data
7. Rights Acknowledgment: Acknowledgment of the data subject's rights under Indonesian law and which rights are being waived or retained
8. Duration: Period for which the release remains valid
9. Signature Block: Space for signatures, dates, and witness information if required
1. Third Party Disclosure: Section specifying authorized third parties who may receive the data, used when data will be shared beyond the primary recipient
2. International Transfer: Details about overseas transfer of data, required when personal data may be transferred outside Indonesia
3. Specific Industry Requirements: Additional provisions required for specific sectors (e.g., healthcare, financial services)
4. Withdrawal of Consent: Detailed procedure for withdrawing consent, included when the organization offers specific withdrawal mechanisms
5. Emergency Contact: Authorization for emergency contact information, included when relevant to the purpose of data collection
1. Schedule A - Details of Personal Data: Comprehensive list of specific personal data items covered by the release
2. Schedule B - Authorized Recipients: List of specific individuals or entities authorized to receive the personal data
3. Schedule C - Processing Activities: Detailed description of all processing activities to be performed on the personal data
4. Appendix 1 - Data Subject Rights: Detailed explanation of data subject rights under Indonesian law
5. Appendix 2 - Security Measures: Description of security measures implemented to protect the personal data
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Financial Services
Education
Technology
Retail
Insurance
Human Resources
Telecommunications
E-commerce
Professional Services
Government Services
Transportation
Hospitality
Relevant Teams
Legal
Compliance
Human Resources
Information Technology
Data Protection
Risk Management
Operations
Customer Service
Information Security
Privacy
Administrative Services
Relevant Roles
Privacy Officer
Data Protection Officer
Legal Counsel
Compliance Manager
HR Manager
Information Security Manager
Risk Manager
Operations Manager
Customer Service Manager
IT Director
Chief Privacy Officer
Chief Legal Officer
Chief Compliance Officer
Data Protection Specialist
Privacy Analyst
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