Republic of the Philippines National Privacy Commission 35. REGISTRATION OF DATA PROCESSING SYSTEM DATA PROTECTION OFFICER ~ DPO Note: Tho gereona infomation suited herein sha be used fr ho ii phase of te DalaProcesing System Online Regan and suparting dimen shouts bo ‘atecned lng with hie form- Ones fam ha en vate by re NPC. ye wil be ven an acess cada via oma and SMS comine wih your estaton wi fe one ‘eter. You may fd heh of ppeing documents in our guidlines orate o you vera and posted incur wobsie. PERSONAL INFORMATION CONTROLLER TIAEOF THE ORDINATION ‘WeSSTE (UR) Ewa, ‘COMPANY ADDRESS TELNO. EAD OF THE ORGANIZATION insane Ba FRSTNANE TELNO, cae HODLE TAL = = (GFFICIAL DESIGNATION (CEOIPRESIDENT DATA PROTECTION OFFICER TASTE Ba FRSTNANE i TELNO, INDE WAL : ‘WOBLENO, ‘OFFICIAL DESIGNATION “STATUS (PERMANENT: YIN?) ‘SWORN STATEMENT | declare underoath thal his Registration Form is accomplished by Data Protection Officer, andis 2 tuo, coeet and comploe statement and pursuant to the pr ‘Nalonal Privacy Commission to vrfyfvalidate the contents stato herein. Head of Agency Data Protecion Officer (Signature over Printed Name) (Signature over Printed Name) SUBSCRIBE and SWORN to before me, tis, who exhibited lo me (hismher) Government issued ID No. issued ot on Notary Pubic Doe. No Page No, Book No, Seresof ‘ "TOBE FILLED UP BY NFC-COMPLANGE AND MONITORING OWSION™™ WAC ACCESECODE, "APPROVED BY (SIGNATURE OVER PAINTED NANE) [__ |