Legal GDPR Consent Form

LEGAL GDPR CONSENT FORM

This GDPR Consent Form (the "Agreement") is entered into between Controller Name: with registered address at (the "Controller"), and Data Subject Name: Contact (email or phone): on this Day: Month: Year: .

RECITALS

WHEREAS the Controller collects, stores and processes certain personal data relating to the Data Subject in connection with the Controller's operations and the purposes set out in this Agreement;

WHEREAS the Controller requires the explicit, informed and unambiguous consent of the Data Subject where processing is based on consent under applicable data protection law; and

WHEREAS the Data Subject has reviewed the processing purposes, categories of data, recipients and retention periods as set forth below and is willing to provide consent on the terms of this Agreement.

NOW, THEREFORE

In consideration of the mutual covenants contained herein, the parties agree as follows:

1. DEFINITIONS

1.1 "Personal Data" means any information relating to an identified or identifiable natural person. 1.2 "Processing" means any operation or set of operations performed upon Personal Data, including collection, recording, organization, structuring, storage, adaptation, retrieval, consultation, use, disclosure, erasure and destruction. 1.3 Terms defined in applicable data protection law have the same meaning here.

2. SCOPE, PURPOSES AND LAWFUL BASIS

2.1 The Data Subject hereby gives explicit consent to the Controller to Process Personal Data for the following specific purposes (select those that apply and provide further detail where requested):

Provision of contracted services, account administration and performance of obligations under an agreement with the Data Subject.

Direct marketing communications (including by email, post and telephone) — the Data Subject authorizes promotional contact for products and services.

Profiling and analytics for service personalization and customer experience improvement.

3. CATEGORIES OF PERSONAL DATA

The Controller may Process the following categories of Personal Data relating to the Data Subject:

Identification data (name, date of birth, identification numbers).

Contact data (email, telephone, postal address).

Financial data (bank details, payment history) where necessary for performance of services.

Special categories of data (health, racial or ethnic origin, political opinions, religious beliefs) — explicit consent required if selected.

4. RECIPIENTS AND TRANSFERS

4.1 Personal Data may be disclosed to Controller affiliates, service providers, processors and professional advisers where necessary to achieve the Purposes. Such recipients will be bound by contractual obligations to protect Personal Data.

4.2 Where Personal Data is transferred outside the European Economic Area, the Controller will implement appropriate safeguards required by applicable law to protect the Data Subject's rights and will document such safeguards.

5. RETENTION

5.1 Personal Data will be retained only for the period necessary to fulfil the Purposes and to comply with legal obligations. Specify retention period where applicable:

6. DATA SUBJECT RIGHTS

6.1 The Data Subject has the right to request access to Personal Data, rectification, erasure, restriction of processing, data portability, object to processing and to withdraw consent at any time. To exercise these rights, contact details are provided below.

7. WITHDRAWAL OF CONSENT

7.1 The Data Subject may withdraw consent at any time by notifying the Controller in writing to the contact details above. Withdrawal does not affect the lawfulness of processing based on consent prior to withdrawal.

I acknowledge that withdrawal of consent will not affect processing carried out prior to withdrawal.

8. SECURITY

The Controller shall implement and maintain appropriate technical and organizational measures to protect Personal Data against unauthorized or unlawful processing and against accidental loss, destruction or damage, taking into account the state of the art and the nature of the data.

9. LIABILITY AND INDEMNITY

The Controller is responsible for compliance with applicable data protection obligations with respect to the Processing activities described herein. To the extent permitted by law, each party shall indemnify the other against losses arising from breach of its obligations under this Agreement.

10. NOTICES

All notices required under this Agreement shall be given in writing and delivered to the contact information set out in this form. Notices are effective upon receipt.

11. AMENDMENTS, COUNTERPARTS AND WAIVER

11.1 No amendment to this Agreement shall be effective unless in writing and signed by both parties. 11.2 This Agreement may be executed in counterparts, each of which constitutes an original. 11.3 Failure or delay to enforce any right is not a waiver of that right.

12. GOVERNING LAW, ENTIRE AGREEMENT AND SEVERABILITY

12.1 This Agreement is governed by the laws applicable to the Controller's principal place of business as indicated in the Controller Address field. 12.2 This Agreement constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior agreements. 12.3 If any provision is held invalid or unenforceable, the remainder of the Agreement shall remain in full force and effect.

CONSENT AND DECLARATIONS

By signing below, the Data Subject confirms that they have read and understood the purposes for which Personal Data will be Processed, that the information provided is accurate, and that consent is given freely for the selected purposes. The Data Subject also declares that where special categories of data are provided, such provision is explicit and voluntary.

I consent to the Processing activities selected in this form:

I expressly consent to the Controller Processing my Personal Data for the purposes selected above.

Where indicated, I expressly consent to Processing of special categories of Personal Data.

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