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1. Identification of Parties: Details of the individual/entity authorizing the release (Authorizer) and the party/organization authorized to release the information (Holder), including full legal names, addresses, and relevant identification numbers
2. Purpose of Authorization: Clear statement of the specific purpose for which the confidential information is being released
3. Information to be Released: Detailed description of the specific confidential information authorized for release, with clear boundaries and limitations
4. Recipient Information: Identity and details of the party/parties authorized to receive the confidential information
5. Duration of Authorization: Specific timeframe for which the authorization remains valid, including start and end dates
6. Rights and Responsibilities: Outline of the rights and responsibilities of all parties involved in the information release
7. Revocation Clause: Terms and conditions under which the authorization can be revoked by the authorizing party
8. Signature and Declaration: Formal declaration of understanding and agreement, with spaces for signatures, dates, and witness details if required
1. Security Measures: Specific security requirements for handling and transmitting the confidential information, recommended when dealing with highly sensitive data
2. Re-disclosure Provisions: Terms governing any potential re-disclosure of the information by the recipient, important for cases where information might need to be shared with additional parties
3. Compensation Details: Any fees or costs associated with the information release, included when there are financial implications
4. Emergency Disclosure Provisions: Special conditions for emergency release of information, particularly relevant for medical or critical business information
5. Digital Authentication Methods: Specific provisions for electronic verification and authentication, needed when dealing with digital information systems
1. Schedule A - Detailed Information List: Comprehensive list of all specific confidential information covered by the authorization
2. Schedule B - Authorized Recipients: Complete list of all authorized recipients and their contact details, if multiple recipients are involved
3. Schedule C - Security Protocols: Detailed security procedures and requirements for handling the confidential information
4. Appendix 1 - Consent Forms: Any additional consent forms required under Indonesian law for specific types of information
5. Appendix 2 - Verification Documents: Copies of identification documents or other verification materials required to validate the authorization
Healthcare and Medical Services
Financial Services
Legal Services
Technology and IT
Manufacturing
Professional Services
Education
Banking
Insurance
Telecommunications
Government and Public Sector
Research and Development
Pharmaceuticals
Human Resources
Consulting
Legal
Compliance
Risk Management
Human Resources
Information Security
Data Protection
Corporate Governance
Records Management
Information Technology
Administrative Services
Legal Counsel
Compliance Officer
Data Protection Officer
Privacy Manager
Risk Manager
Corporate Secretary
Human Resources Director
Information Security Manager
Chief Information Officer
Chief Legal Officer
Chief Compliance Officer
Records Manager
Business Unit Manager
Executive Director
General Manager
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ұԾ’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
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We do not train on your data; ұԾ’s AI improves independently
All data stored on Genie is private to your organisation
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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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