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PRIVACY AND CONSENT RELATED TO PROTECTION OF PERSONAL INFORMATION (POPI) ACT
(NB: This serves as an addendum to your contract of employment/part-time/service/locum contract - whichever is applicable)
Preamble:
The consent and privacy clauses hereunder assist the Company and yourself to comply with POPI Act which aims to protect
“personal information” and to strike a balance between the right to privacy and the need for freedom of access to information, and to
control how personal information is “processed”.
1. UNDERTAKING REGARDING THE PROTECTION OF PERSONAL/PRIVATE INFORMATION
(a) The Company hereby undertakes to ensure that it safeguard and protect your personal information to the best of its abilities.
(b) The Company and its delegated official(s) or any authorized persons / entity shall respect your privacy and endeavour to
keep your sensitive personal information private, including notifying you when your information is collected/shared.
(c) You have the right to access, view or edit your personal information, including to permit or deny the Company to share your
personal information and to request the Company to delete your personal information from its databases, services providers
or associates etc.
(d) The Company will however retain information for an example as required by law, legal processes, auditing or reporting
purposes and/or as per Chapter 2 (3) and Chapter 4 of the Protection of Personal Information (POPI) Act of 2013.
(e) Should there be a data breach or compromise of the Company’s IT systems or unauthorized access to or theft of your
personal information, the Company will inform the relevant authorities, you or your nominated next of kin via the most
convenient method like SMS or email. The Company may also send updates regarding the progress and outcome of the
investigation via same method(s).
You are therefore expected to ensure that your contact details/information is up to date.
Please provide your latest contact details and those of your next of kin:
YOUR DETAILS YOUR NEXT OF KIN’S DETAILS
Full Names:
Cell Number:
Email Address:
(f) You are advised to contact our Senior HR Manager and Information Officer, Mr Solly Moagi or your manager for matters
regarding your personal information.
The contact details of our Information Officer are as follows:
Office Telephone : 086 111 7622 / 012 440 6023
Email Address : hr@[Link]
2. CONSENT FOR PROCESSING (USE/STORAGE/SHARING) OF PERSONAL INFORMATION
(a) You acknowledge and give consent that the Company (Employer) or its delegated official or any authorized person / entity
shall be entitled to process your personal information (including special personal information) for the purposed permitted by
law, for work-related purposes like HR processes, payroll processes, health and safety, legal processes and/or for purposes
as contemplated in Chapter 2 (3) and Chapter 4 of the Protection of Personal Information Act of 2013.
Initials
Tel : 0861 117 622 | Fax : 0861 114 612 | Address: 2nd Floor Provisus Building | 523 Stanza Bopape Street | Arcadia | Pretoria | 0083
PO Box 29824 | Sunnyside | 0132
[Link]
Director: Snoekie L Mabena -[Link] Nursing Agency t/n [Link] AGENCY. Reg no: 2012/178997/07 (Pty) Ltd
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(b) You agree that the Company (Employer) or its delegated official or any authorized person / entity shall be permitted to retain
and use your personal information as the Company may occasionally require for its legitimate business purposes and/or as
stated above / as per Chapter 2 (3) and Chapter 4 of the Protection of Personal Information Act of 2013.
(c) The personal information that can be processed (used, stored or shared) include:
• Full Names; Surname; Identification Number / Passport Number; Date of Birth; Citizenship / Nationality; Gender; Race;
Nationality; Marital Status; Disability Status; Qualifications; Partner / Spouse Details; Dependents / Beneficiaries
Details; Work Address; Email Address; Residential Address; Telephone / Cellular Phone Numbers; Banking Details;
Professional Registration Information; Practice Number; Job Title; Employment Details (e.g. Employee Number, Job
description, Occupation data, Employment history, Service record, Hours of work, Pay rate / salary, Payroll data)
(d) You confirm your consent regarding processing (use/storing/sharing) of your information as follows:
I, ID No: hereby
(Full Names)
(NB: Use X or √ to mark your selection and/or delete what you don’t consent to)
DO NOT GIVE the Company permission to share or use my personal information for any other purpose except for work
related purposes like for payroll processes, human resources related processes, government authorities like SARS,
Department of Labour, CCMA, SAPS and any authorized entity / person as per the Protection of Personal Information
Act 4 of 2013 and Promotion of Access to Information Act 2 of 2000.
GIVE the Company permission to share any of my relevant personal information with the Company’s
associates/affiliates/authorized entities for purposes like advertising, promotions, marketing or research.
Do you want the Company to hide your identity / de-identify your information when sharing your personal information?
Yes: No:
Signed at on this day
(Town / City) (Date: day/month/year)
Signature
3. DEALING WITH NON-COMPLIANCE WITH THE PRIVACY CLAUSES AND CONSENT
Contravention of the POPI Act prescripts, privacy clause(s) and/or undertakings is viewed as a serious offence. The Company will take
harsh disciplinary action against those who contravene the POPI Act prescripts, privacy clause(s) and/or undertakings.
Alternatively, the Company or the subject and/or the Information Regulator may take appropriate legal action, civil action or open criminal
case(s) against perpetrators.
Initials
Tel : 0861 117 622 | Fax : 0861 114 612 | Address: 2nd Floor Provisus Building | 523 Stanza Bopape Street | Arcadia | Pretoria | 0083
PO Box 29824 | Sunnyside | 0132
[Link]
Director: Snoekie L Mabena -[Link] Nursing Agency t/n [Link] AGENCY. Reg no: 2012/178997/07 (Pty) Ltd
