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Withdrawal of Consent Form

Right to Withdraw Consent under Article 7 of the General Data Protection Regulation (GDPR)

Section 1 – Requestor Details

- This section includes details of the individual / company submitting this request.
- All fields marked as * are mandatory.

Section 2 – Data Subject Details

- This section includes details of the individual whose personal data is requested
- A separate form must be completed for each data subject
- All fields marked as * are mandatory.

Section 3 – Details of the Request
Section 4 – Declaration (Mandatory)