Confidential Information Authority Form

THIS CONFIDENTIAL INFORMATION AUTHORITY FORM (the "Authority Form") is dated:

(The individual proposing the project)
(Please enter the name of the person representing the partner organisation)
(Email address of partner organisation representative)
(The "Organisation" forming a partnership with you during the project)

(1) BACKGROUND

1.1 Why does the Organisation potentially need to gather confidential information?

As part of an Agreement to provide support for you during the project named above, the ability to gather confidential information as described below (see 1.2) may prove to be essential by the Organisation listed above to facilitate the completion of works as outlined within the terms of this Agreement. For example:

  • Enabling the Organisation to make the most informed decisions possible regarding contextual factors.

  • Determining if the aid of external specialists is necessary to promote the best outcomes.

  • Ensuring that the most appropriate team member is utilised as a resource to address concerns.

1.2 What kinds of Confidential Information may the Organisation need to gather?

  • “Confidential Information” refers to data or information relating to the body or business that you represent, and which may or may not be considered proprietary depending on the context. This kind of information may be encountered during service delivery for the project and may include, but is not limited to:

    > Systems, Processes and Procedures
    > Accounting records
    > Client records
    > Intellectual Property

The Organisation does not claim to have ownership of any Confidential Information gathered during the course of service delivery and will relinquish or destroy (as required) all Confidential Information and associated records provided by you upon conclusion of the service. All Confidential Information will be treated in accordance with the terms outlined by the the Organisation's applicable privacy, confidentiality, and intellectual property policy(s).

(2) SIGNATURE

By signing this Authority Form, you understand and agree that:

  • The Organisation will not share, modify, or otherwise distribute Confidential Information within or beyond the organisation without the explicit approval granted by you within this Authority Form.

  • The Organisation at no point will share, modify, or otherwise distribute any Confidential Information within or beyond the organisation that could reasonably be expected to cause harm to you or the organisation you represent.

  • You may withdraw the authority provided by this form at any time (subject to the terms of notice detailed within any Agreement signed between you and your representatives and the Organisation and its representatives.)

  • You may contact the Organisation directly by phone or email at any time regarding any questions that you may have.

IN WITNESS WHEREOF the Parties have duly affixed their names and signatures on the date specified below:

Signee (Yourself as an Individual or representing an Organisation)

(If applicable)
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Signee ("the Organisation" providing services)

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