Free Personal Privacy Form Template

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Free Personal Privacy Form Template

Personal Privacy Form

Please fill out this form to provide and manage your personal privacy preferences.

Personal Information

Name

    Date of Birth

      Address

        Phone number

          Email

            Privacy Preferences

            Please indicate your privacy preferences below

              • I agree to share my personal information with the specified parties.

              • I prefer to keep my personal information confidential.

              • I would like to receive marketing communications from the company.

              • I would prefer not to receive marketing communications.

              Data Usage Consent

              Please specify your consent for how your personal data will be used

                • I consent to my personal data being used for internal purposes only.

                • I consent to my personal data being used for research and analysis purposes.

                • I consent to my personal data being shared with third-party partners for business-related activities.

                Data Retention

                How long would you like your personal data to be retained?

                  • Until I request its removal

                  • For the specified period as per the company policy

                  • I would like my data to be deleted after a certain period

                  Access and Control

                  You have the right to access and manage your personal data. Please check the options that apply

                    • I would like to request access to the personal information the company holds about me.

                    • I would like to request a correction to my personal information.

                    • I would like to request the deletion of my personal information.

                    • I would like to opt out of profiling or automated decision-making processes based on my data.

                    Consent for Data Transfers

                    Please indicate your consent for transferring your data to other countries

                      • I consent to my data being transferred internationally in compliance with applicable laws.

                      • I do not consent to my data being transferred internationally.

                      Signature and Acknowledgment

                      By signing below, I confirm that I have read, understood, and voluntarily agree to the terms outlined above regarding the management and processing of my personal privacy preferences.

                      Name:

                      Date:

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