NPC Issuance Wiki

Annex 1

Issued Circular

Issuance Text

ANNEX 1

REPUBLIC OF THE PHILIPPINES)
CITY OF _______________________) S.S.

SWORN DECLARATION AND UNDERTAKING FOR EXEMPTION FROM REGISTRATION OF DATA PROCESSING SYSTEMS

I [Name of Data Protection Officer/Authorized Representative], of legal age, and residing at [Address of DPO/Authorized Representative], after having been duly sworn in accordance with law, do hereby depose and state that:

  1. I am the [Data Protection Officer (“DPO”) or Authorized Representative] of [Name of PIC/PIP] with the following contact details:

    • a. Office Address: ________________________;
    • b. DPO Name: (if through Authorized Representative);
    • c. DPO Email Address: ___________________; and
    • d. Contact Number: __________________;

  2. I am duly authorized to issue this Sworn Declaration and Undertaking on behalf of [Name of PIC/ PIP] as manifested in the attached [proof of authority such as a Board Resolution embodied in a Secretary’s Certificate];

  3. [Name of PIC/PIP] does not meet the registration requirements for all of the following reasons:

    • [Name of PIC/PIP] employs less than two hundred fifty (250) persons;
    • the processing by [Name of PIC/PIP] does not include sensitive personal information of at least one thousand (1,000) individuals;
    • [Name of PIC/PIP] does not process any information likely to pose a risk to the rights and freedoms of data subjects including those that involve information likely to affect national security, public safety, public order, or public health or information required by applicable laws or rules to be confidential; vulnerable data subjects like minors, the mentally ill, asylum seekers, the elderly, patients, those involving criminal offenses, or in any other case where an imbalance exists in the relationship between a data subject and a PIC or PIP, especially those involving automated decision-making or profiling; and
    • [Name of PIC/PIP] is not a government agency or instrumentality;

  4. I undertake that [Name of PIC/PIP] shall comply with orders of the Commission requiring the submission of additional documents and other relevant information, and that failure to comply with such orders will be subject to fines and other applicable penalties;

  5. I undertake to immediately inform the Commission by filing a new Sworn Declaration and Undertaking within ten (10) days from any change in the declarations in number 1;

  6. I undertake to immediately register with the Commission within twenty (20) days from existence of facts showing that the basis for this Sworn Declaration and Undertaking is no longer true;

  7. I am executing this Sworn Declaration and Undertaking to attest to the truth of the foregoing statements and to comply with the requirements of the Data Privacy Act, its Implementing Rules and Regulations, and other relevant issuances of the National Privacy Commission.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of ______________, 20__ at ____________, Philippines.

[Name of Data Protection Officer/Authorized Representative]
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of ______, 20__, Affiant exhibiting to me a competent proof of identity ___________________________________ issued at _____________________ on _______________________.

NOTARY PUBLIC

Doc No. _____;
Page No. ____;
Book No. ____;
Series of _____.

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