The Statement of Consent is a crucial legal document used in Indonesia to obtain and record explicit permission from individuals for various purposes, including personal data processing, medical procedures, research participation, or service provision. This document type has gained increased significance following the implementation of Indonesia's Personal Data Protection Law (UU PDP) and must comply with both this law and the Indonesian Civil Code. The Statement of Consent should clearly outline the scope of permission granted, include all necessary information for informed decision-making, and detail the rights of the consenting party. It serves as evidence of compliance with legal requirements and protects both the consenting individual and the receiving party.
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1. Identification of Parties: Details of the person giving consent and the party receiving consent, including full names, addresses, and relevant identification numbers
2. Declaration of Capacity: Statement confirming the consenting party has legal capacity to give consent and is of sound mind
3. Purpose of Consent: Clear explanation of what the consent is for and how it will be used
4. Scope of Consent: Detailed description of what is being consented to, including any limitations or restrictions
5. Duration of Consent: Period for which the consent remains valid, including start and end dates if applicable
6. Right of Withdrawal: Information about the right to withdraw consent and the process for doing so
7. Declarations: Statements confirming understanding of the consent and that it is given freely
8. Execution: Signature section with date and witness provisions
1. Data Processing Details: Required when consent involves personal data processing, specifying what data will be collected and how it will be used
2. Third Party Disclosures: Include when information or rights under the consent may be shared with or transferred to third parties
3. Risk Acknowledgment: Required for medical procedures or high-risk activities, outlining potential risks and consequences
4. Guardian Details: Required when consent is given on behalf of a minor or person lacking capacity
5. Translation Declaration: Required when the consent form is provided in multiple languages or translated from another language
1. Schedule 1 - Detailed Description of Activities: Comprehensive list of specific activities or procedures being consented to
2. Schedule 2 - Information Sheet: Detailed information provided to the consenting party to ensure informed consent
3. Appendix A - Supporting Documentation: Copies of relevant identification documents or supporting materials
4. Appendix B - Withdrawal Form: Template form for withdrawing consent if needed in the future
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