October 11,2021

Dear Member,

To ensure the safe and transparent usage of your personal information, we require that you read and fully
understand the provisions stated in this document. This is in compliance with the Republic Act 10173,
also known as the Philippine Data Privacy Act of 2012, whose implementing rules and regulations took
effect on September 9, 2016. We are providing you with this letter to inform and secure your consent.

DATA PRIVACY CONSENT

1. I hereby agree and consent that PUP JPIA Manila will share my personal information (e.g.
“person to contact in case of emergency”) written on this form;
2. I authorize the PUP JPIA Manila to collect, use, share, retain and/or process my information for
holistic development only as Accountancy and Management Accounting student;
3. I acknowledge and agree that the company that will sponsor the future events of PUP JPIA
Manila may communicate with me in furtherance of my employment only;
4. I do not allow the sponsoring company to share my personal information to a third party;
5. I allow the sponsoring company to retain my personal information for one (1) year only, from the
date of this Consent, after which the company shall destroy my personal data and remove it from
their filling systems to prevent further unauthorized use; and
6. I acknowledge that I am 18 years old or older when I completed this Consent Form.

Basic Rights of the Data Subject

[Source: RA 10173 https://privacy.gov.ph/data-privacy-act/]

As the Data Subject, you are afforded the following rights as written in RA 10173 otherwise known as the
Data Privacy Act of 2012.
1. The right to be informed whether personal information pertaining to him/her shall be and are
being or have been processed.
2. The right to be furnished with the information before the entry of his or her personal information
into the processing system of the personal information controller.
3. The right to reasonable access to the data subject’s information upon demand.
4. The right to dispute the inaccuracy or error in the personal information and have the personal
information controller correct it immediately and accordingly, unless the request is vexatious or
otherwise unreasonable.
 5. The right to suspend, withdraw, or order blocking, removal or destruction of his or her personal
information from the personal information controller’s filing system upon discovery.
6. Any substantial proof that the personal information is incomplete, outdated, false, unlawfully
obtained, used for unauthorized purposes or is no longer necessary for the purposes for which
they were collected.
7. The right to be indemnified for any damages sustained due to such inaccurate, incomplete, out-
dated, false, unlawfully obtained or unauthorized use of personal information.
8. The right to data portability thru the ability to obtain from the personal information controller a
copy of data undergoing processing in an electronic or structured format, which is commonly
used and allows further use by the data subject.
9. The right to lodge a complaint before the National Privacy Commission.

Do you give consent to the sharing of your personal data to PUP JPIA Manila for academic and/or non-
academic purposes?

Yes. I, Shena F. Ricamara, acknowledged that I am 18 years old or older upon signing this
YES
consent form.

No, I do not give my consent.

SHENA F. RICAMARA
Signature over Printed Name

10/11/21
Date