Data Release Form

A data release form is an effective tool widely used to request for releasing certain data required to fulfil some official purposes. In such a release form, the fundamental details of data type release are mentioned to ensure that necessary data is issued to the data receiver party without disclosing the protected information.

Sample Data release form:

Details of the Data receiver:

Name of the Data receiver firm/ company/ individual: _______________________

Official Address:

Street: _______________ City: ______________ State: _______________ Country: ___________________ PIN: _______________

Contact number: ________________________

E-mail id: _______________________________

Website (if any): _________________________

Detail of data release:

Name of the department: _______________

Type of the data to be released: ___________________ textual document/ CD/ DVD/ Report

Category: ____________________________________ official/ personal/ Financial/ social

Data account reference number: ______________

The above printed data type belongs to company/ unit/ individual: _________________

Date of data release: ____/ _____/ ____

Details of the data release party:

Name of the data release company/ firm/ individual: _________________

Street Name: _______________ City: _____________State: ______________ Country: _______________ ZIP: ________________

Authorized contact number: _____________

E-mail id: ____________________________

Website: _____________________________

Data

Signed by the Data receiver: _________________

Signed by the Data release: ___________________

Signature of the department head: _____________

Date: ____/ ____/ ____

Official seal: ___________________

Category: Release Forms