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MI 273C Data Privacy Consent Form REV

This consent form allows the Maritime Administrator to provide requested services by using an individual's personal information. Consent can be withdrawn at any time but may impact applications and services. Information will be stored legally and individuals have rights to access and correct their data. Contact information is provided for data withdrawal requests or questions. A privacy policy provides more details and is available online or by request. Consent is given to use information for seafarer documentation, online verification, processing by third parties for compliance, and international storage and transfers related to applications or legal requirements. Security measures are in place but may not meet an individual's country's standards. Optional marketing consent is also included.

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Renz Gaming
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432 views

MI 273C Data Privacy Consent Form REV

This consent form allows the Maritime Administrator to provide requested services by using an individual's personal information. Consent can be withdrawn at any time but may impact applications and services. Information will be stored legally and individuals have rights to access and correct their data. Contact information is provided for data withdrawal requests or questions. A privacy policy provides more details and is available online or by request. Consent is given to use information for seafarer documentation, online verification, processing by third parties for compliance, and international storage and transfers related to applications or legal requirements. Security measures are in place but may not meet an individual's country's standards. Optional marketing consent is also included.

Uploaded by

Renz Gaming
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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REPUBLIC OF THE MARSHALL ISLANDS

MARITIME ADMINISTRATOR

Data Privacy Consent Form for Seafarers and Filing Agents

In order for the Maritime Administrator to provide you with the requested service(s), please
complete this consent form. You may withdraw your consent at any time, but doing so may affect
your application and the availability of other services. Your information will be stored for as long
as legally permitted. You have the right to receive a copy of and to correct your data at any time.
Contact dataprivacy@register-iri.com for any data withdrawal requests or other questions or
concerns. The full privacy policy is available at: https://www.register-iri.com/index.cfm (free
hardcopy available upon request).

I consent to allow my personal information to be:

For Seafarers:
 Used to obtain seafarer documentation to serve on board a Republic of the Marshall Islands
(RMI) flagged vessel pursuant to RMI laws and regulations. I understand that I may be
required to provide additional information in order to maintain and/or update my
documentation.
 Accessible online for document verification purposes.

For Seafarers and Filing Agents:


 Provided to the RMI Maritime Administrator (the information controller) and International
Registries, Inc. and its affiliates (IRI) or third parties contracted by one of the preceding
entities to carry out administrative and technical support.
 Processed by a contracted third-party to ensure compliance with due diligence
requirements and trade restrictions. I understand that I may be required to provide
additional information in order to meet these requirements.
 Transferred and stored internationally to process this application and for incidental
purposes such as port State control requests, marine safety investigations, and other legal
requirements.

Physical and technological safeguards are in place to keep your information secure. Please
be aware that these may not meet the same standard as is required by the country in which
you reside.

Rev. Jun/2018 MI-273C


Republic of the Marshall Islands
Optional:

Please check the box to opt-in to allow your personal information to be used for marketing
purposes which includes event invitations, newsletters, and blog, maritime, and corporate
updates, among others.

Eufrecio L. Cleofe
Print Name

02 - 06 - 2022
Signature Date

Rev. Jun/2018 MI-273C


Republic of the Marshall Islands

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