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02i) Annex X Declaration_data protection


Annex X: Declaration of Consent pursuant to the Austrian Data Protection Act [Datenschutzgesetz]

Pursuant to Section 8 (1) (2) and Section 9 (6) of the Austrian Data Protection Act [Datenschutzgesetz]
2000, BGBl. [Federal Law Gazette] I No. 165/1999, as amended, the Beneficiary hereby explicitly declares
his consent that the following data may be used for the purpose of unrestricted processing and editing,
publication and disclosure to third parties:

- Title of the contract
- Amount of contract and contract duration
- Name and address and nationality of the Beneficiary

This Declaration of Consent may be revoked by the Beneficiary at any time. The revocation must be issued
to ADA in writing in order to obtain effect. Upon receipt of such revocation any further transmission of data
shall be immediately discontinued notwithstanding any existing statutory transmission duties.



., ...... ....... ................

The Beneficiary:
(legally valid signature required)

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