The Release of Information Form is a crucial document in Indonesia's data protection landscape, designed to facilitate lawful and transparent sharing of personal information while protecting individual privacy rights. This document becomes necessary whenever personal data needs to be shared between organizations or individuals, whether for healthcare, employment, educational, or other purposes. The form must comply with Indonesia's Personal Data Protection Law (Law No. 27 of 2022) and related regulations, including specific provisions for electronic information handling and sector-specific requirements. It serves as both a consent mechanism and a record of authorization, detailing what information can be shared, with whom, for what purpose, and for how long. The document is particularly important in contexts where sensitive personal data is involved or when information needs to be transferred across organizational or jurisdictional boundaries.
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1. Header Information: Document title, date, and form identification number
2. Data Subject Information: Full details of the individual whose information will be released (name, ID number, contact details, etc.)
3. Requesting Party Information: Details of the organization/individual requesting the information
4. Recipient Information: Details of who will receive the information
5. Information to be Released: Specific description of the information authorized for release
6. Purpose of Release: Clear statement of why the information is being released and how it will be used
7. Duration of Authorization: Time period for which the authorization is valid
8. Rights and Revocation: Statement of the data subject's rights and how to revoke authorization
9. Signatures: Signature blocks for all required parties including witnesses if needed
1. Special Categories of Data: Additional authorizations for sensitive personal data (medical, financial, etc.) - include when sensitive data is involved
2. Electronic Distribution Authorization: Specific permission for electronic transmission of information - include when digital transfer is anticipated
3. Third Party Access: Authorization for additional parties to access the information - include when third-party access might be needed
4. International Transfer Provisions: Specific provisions for cross-border data transfers - include when information will be sent outside Indonesia
5. Emergency Contact: Emergency contact information - include for medical or sensitive personal information releases
1. Detailed Information List: Itemized list of specific documents/information to be released
2. Authorized Recipients List: Complete list of authorized recipients if multiple parties are involved
3. Data Processing Requirements: Specific requirements for how the information should be handled, stored, and protected
4. Privacy Notice: Detailed privacy notice explaining how the information will be protected and used
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Relevant Industries
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Banking and Financial Services
Education
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Human Resources
Government and Public Services
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Technology and Communications
Professional Services
Research and Development
Relevant Teams
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Compliance
Human Resources
Information Security
Privacy
Records Management
Operations
Risk Management
Administrative Services
Data Protection
Relevant Roles
Privacy Officer
Data Protection Officer
Compliance Manager
Legal Counsel
Human Resources Manager
Medical Records Administrator
Information Security Officer
Risk Manager
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Administrative Coordinator
Healthcare Administrator
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