I hereby agree and give my consent that the City/Municipality of ________ and National Government Agencies may, in accordance with the Data Privacy Act of 2012 (Republic Act No. 10173), its Implementing Rules and Regulations, and applicable privacy policies, collect, record, organize, store, update, retrieve, use, consolidate, block, erase, or otherwise process my personal information and sensitive personal information.

This personal information may include, but is not limited to, the following:

• Name, address, contact numbers, email address, and other contact information;
• Date of birth and other personal data required for identification and documentation;
• Government-issued identification numbers and details;
• Financial and banking information, when required for specific services or benefits;
• Other information that may affect my eligibility for Local Government or National Government programs and services; and
• Any additional information necessary for the proper delivery of government services.

I hereby authorize the City/Municipality and National Government Agencies to process, use, and disclose my personal information to the extent necessary and appropriate for the following lawful purposes:

• To establish, verify, update, and maintain my records;
• To administer my applications, accounts, services, facilities, or benefits;
• To assess, validate, and monitor my eligibility, entitlements, and benefits;
• To determine benefits received and collect data required for proper implementation;
• To support development planning, citizen research, audit, and administrative functions; and
• To carry out any other legitimate government purposes as allowed by law.

I further consent that my personal information may be disclosed, in the ordinary course of government operations, to the following parties, solely for the purposes stated above:

• Authorized agents, contractors, or third-party service providers engaged by the government;
• Other local or national government agencies, regulatory bodies, tax authorities, or law enforcement agencies, when required by law.

I acknowledge that I have the right to:

• Access my personal data;
• Request the correction of any inaccurate or incomplete information; and
• Request the deletion or destruction of my personal data when it is no longer necessary for the purpose for which it was collected, subject to existing laws and government procedures.

By proceeding, I confirm that I have read, understood, and voluntarily agreed to the collection, use, and processing of my personal information as stated above.