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1. Identification of Parties: Details of the record holder (releasing party), the requesting party, and the subject of the records (if different from the requesting party)
2. Record Details: Specific description and scope of records to be released, including date ranges and types of records
3. Purpose of Release: Clear statement of the intended purpose for which the records are being released
4. Authorization Statement: Explicit authorization for the release of records, including reference to relevant laws (POPIA/PAIA)
5. Duration of Authorization: Time period for which the authorization remains valid
6. Rights and Responsibilities: Statement of rights retained by the subject and responsibilities of the receiving party
7. Signature Block: Space for signatures, dates, and witness details where required
1. Third Party Authorization: Additional authorization section when records are being released to someone other than the subject
2. Special Categories of Information: Additional provisions for sensitive information such as health records, financial records, or other protected categories
3. Electronic Records Provision: Specific provisions for electronic format records and their transmission
4. Revocation Rights: Details about the right to revoke the authorization and the process for doing so
5. Cost Recovery: Terms regarding any fees or costs associated with the record release
1. Schedule A - Detailed Record List: Itemized list of specific records to be released, including reference numbers, dates, and descriptions
2. Schedule B - Special Authorizations: Any specific authorizations required for particular types of records (e.g., medical, financial)
3. Schedule C - Proof of Identity: Requirements and acceptable forms of identification for verification purposes
4. Appendix 1 - Processing Details: Information about how the records will be processed, transmitted, and handled
Healthcare
Financial Services
Education
Legal Services
Government and Public Sector
Insurance
Human Resources
Corporate Services
Professional Services
Real Estate
Banking
Telecommunications
Legal
Compliance
Records Management
Information Security
Data Protection
Administrative Services
Risk Management
Operations
Information Management
Document Control
Privacy
Data Protection Officer
Information Officer
Compliance Manager
Legal Counsel
Records Manager
Privacy Officer
Healthcare Administrator
Human Resources Manager
Company Secretary
Risk Manager
Operations Manager
Administrative Officer
Document Controller
Compliance Officer
Information Security Manager
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